The Department of Health Care Services’ (DHCS) Class Action Recovery Program seeks reimbursement for services that Medi-Cal paid for on behalf of its beneficiaries who are involved in third party actions, such as product liability, vaccine/ medication-related injuries, and exposure to asbestos/ other environmental toxins. When a Medi-Cal beneficiary receives a class action or mass tort settlement, judgment, or award from a liable third party, as compensation for injuries they incurred, the Class Action Recovery Program is required by federal and state law to recover funds for any related services paid for by Medi-Cal.
For claims involving personal injury, medical malpractice, or workers’ compensation, use the links below to be directed to the appropriate recovery unit’s website.
Lien Process
When a Medi-Cal beneficiary is injured by a liable third party, the beneficiary or their representative must report their action or claim in writing to DHCS pursuant to Welfare and Institutions (W&I) Code Section 14124.73.
For each settlement, judgment, or award, the beneficiary, or their representative is required to notify DHCS, so an initial or updated lien may be prepared pursuant to W&I Code Section 14124.76 and 14124.79. DHCS will acquire the medical payment records and work with the beneficiary, or the representative, to establish a lien with an itemization of injury related services subject to collection. DHCS has the right to recover up to the date of settlement and/or full resolution of all actions associated with the injury, pursuant to W&I Code Section 14124.785.
For questions regarding an established Class Action case or if a settlement has occurred, you may contact the unit at ClassAction@dhcs.ca.gov. Please include the name of the beneficiary, the DHCS account number, and the beneficiary's client index number (CIN), or social security number (SSN).
DHCS Lien Overview: Class Action
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Injury Reported to DHCS
Submitting parties must report injuries using the Entitlement Submission template (contact the Class Action Recovery Program for more details at ClassAction@dhcs.ca.gov). All fields on the template must be filled in (e.g., the Medi-Cal beneficiary's social security number (SSN), date of injury, primary injury, settlement date, award value, etc.). -
DHCS Eligibility Check
DHCS will process the Entitlement file and provide the submitting party with a return file. -
Identifying Injury Related Services
DHCS will work with the submitting party to determine the injury related services. -
Finalizing the Liens
Pursuant to W&I Code Section 14124.76, no settlement, judgment, or award is final until Medi-Cal has had a reasonable time to perfect and satisfy the Medi-Cal lien. Once the injury related services have been identified, DHCS will compile and submit the lien to the submitting party. If no injury related services are identified, a “No Lien" letter will be sent to the submitting party.
Paying a Lien
In order to apply a payment to the correct account, the DHCS account number must be included with each payment submission. For your convenience, the following payment options are available:
1. Payment via Electronic Funds Transfers (EFT) – To get started go to the EFT website. Two unique EFT options are available:
- One-Time Payment – For Medi-Cal beneficiaries and entities with few claims.
- Enrolled User Payment – Ideal for entities that
manage numerous cases and make multiple payments. This option allows the user
to schedule future payments and track payment history. To become an enrolled
user, complete the following:
- Step 1: Submit a New Enrollment Request. Allow five (5) business days for DHCS to confirm the information and create your Enrolled User account.
- Step 2: Register as an Enrolled User. Follow the instructions provided by DHCS upon receiving your confirmation of enrollment.
2. Payment via check – Submit to:
Department of Health Care Services
Third Party Liability and Recovery Division
Class Action Unit - MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
Please reference the DHCS account number on the check and allow 15 to 30 business days for DHCS to receive and apply the payment.
If an insurance company issues a single check with both you and DHCS listed, please review instructions under item #25 in the Frequently Asked Questions.
Contact Information
- Email Address: ClassAction@dhcs.ca.gov
- Phone Support Unit (916) 445-9891
- Hours of operation: Monday through Friday - 8:00 a.m. to 5:00 p.m., closed from 12:00 p.m. to 1:00 p.m.
- Closed on weekends and State Holidays
- Online Forms – notify and update DHCS electronically
- Mailing Address for written correspondence:
Department of Health Care Services
Third Party Liability and Recovery Division
Class Action Unit - MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
