Net-to-client after Medicare, Medicaid, ERISA, and hospital liens. Applies procurement-ratio reduction (Rimes/Ahlborn).
Save this breakdown. Enter your email and the net-to-client breakdown above prints to PDF as shown — no watermark, nothing sent to you.
MedLegal AI's full Lien Resolution tool drafts the Medicare/Medicaid reduction requests, parses ERISA plan documents to detect self-funded vs fully-insured, and tracks the negotiation history in case-store so every future demand letter reflects the current net. Starts at $49/mo.
Start free — 3 cases, no card → See all 23 tools →Medicare (MSP). 42 U.S.C. §1395y(b); 42 CFR §411.37. Procurement-ratio reduction: Medicare lien × (attorneyFee + costs) / grossSettlement. Capped so the net Medicare recovery is never less than zero.
Medicaid. Applies Ahlborn (547 U.S. 268, 2006) and Wos v. E.M.A. (568 U.S. 627, 2013): state Medicaid recovery is limited to the portion of settlement attributable to past medical expenses. Many states now apply a formula approach post-Wos; we use a conservative 1/3 default allocation to past medical — verify your state's rule.
ERISA self-funded plans. Post-Montanile v. Board of Trustees (577 U.S. 136, 2016), the plan must trace to specifically identifiable settlement funds. Once funds are dissipated (paid to attorney, client, or other creditors), the plan's equitable lien can disappear. We flag self-funded plans as "strict tracing applies."
ERISA fully-insured plans. Subject to state anti-subrogation / made-whole laws. Often negotiable to 0-33%. We apply the procurement-ratio reduction as a starting point.
Hospital liens. State-specific. Many states require the lien amount be reasonable and customary; some let the hospital collect only Medicare/Medicaid-eligible amounts if the patient was covered. Procurement-ratio reduction often applies by state statute.
Provider bills. Usually the most negotiable category. Apply procurement-ratio reduction + negotiate on basis of "made whole" doctrine (some states).