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LIENS - MEDICAL BILLS - MEDICAID

(Under Section 287.260 RSMo., the compensation payable shall be exempt from attachment, garnishment, and execution, and not in any way liable for any debt.)

In Goldman v Knickerbocker Clothing Company, (LIRC) 1/17/01, the Commission rejected SIF argument that Medicare required notice of lien, PTD awarded for 87-year old claimant who fell down steps and developed a hematoma. (ALJ Denigan)

In Healthnet v The Pleasant Hill Bank, 25 S.W.3d 551 (Mo.App. W.D. 2000) Employee alleged PTD benefits from auto accident while en route to a dinner meeting, ALJ denied claim, employee sought payment of $400K+ in medical expenses from group carrier; insurer argued the employee and employer and worker’ compensation carrier colluded to provide testimony inconsistent with civil case. Commission dismissed claim of third party carrier and found the carrier lacked standing and noted the standing to contest cases on the basis of fraud applied only to a party to the suit

In Mann v Varney Construction, 23 S.W.3d 231 (Mo.App. E.D. 2000), an Employee is entitled to recover only Medicaid-scheduled rates for medical services and not actual bills for services charged by providers, rejecting claimants claim for more than $130,000 in medical bills when Medicaid paid only $31,000.

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