[{"@context":"https:\/\/schema.org\/","@type":"BlogPosting","@id":"https:\/\/www.mamajustice.com\/blog\/what-is-a-tenncare-subrogation-lien-under-tennessee-code-71-5-117\/#BlogPosting","mainEntityOfPage":"https:\/\/www.mamajustice.com\/blog\/what-is-a-tenncare-subrogation-lien-under-tennessee-code-71-5-117\/","headline":"What Is a TennCare Subrogation Lien Under Tennessee Code 71-5-117?","name":"What Is a TennCare Subrogation Lien Under Tennessee Code 71-5-117?","description":"How Tennessee Medicaid Gets Repaid From Your Car Accident Settlement Key Takeaways: A TennCare subrogation lien under Tennessee Code Annotated \u00a7 71-5-117 is the State’s legal right to be reimbursed from your car accident settlement for medical care TennCare paid after your crash. The statute subrogates the State to your rights against the at-fault party,...","datePublished":"2026-09-28","dateModified":"2026-09-28","author":{"@type":"Person","@id":"https:\/\/www.mamajustice.com\/blog\/author\/mamajustice\/#Person","name":"Mama Justice - MW Law Firm","url":"https:\/\/www.mamajustice.com\/blog\/author\/mamajustice\/","identifier":6,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/e447862997b79ed22fd71bb87a11629345f26dae1c12efb64a217ade91b0f64b?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/e447862997b79ed22fd71bb87a11629345f26dae1c12efb64a217ade91b0f64b?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Mama Justice - MW Law Firm","logo":{"@type":"ImageObject","@id":"https:\/\/www.mamajustice.com\/wp-content\/uploads\/2024\/08\/Mama-Justice-Logo-Desktop.png","url":"https:\/\/www.mamajustice.com\/wp-content\/uploads\/2024\/08\/Mama-Justice-Logo-Desktop.png","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/www.mamajustice.com\/wp-content\/uploads\/2026\/09\/tenncare_medicaid_card_and_tennessee_subrogation_lien_document_memphis.webp","url":"https:\/\/www.mamajustice.com\/wp-content\/uploads\/2026\/09\/tenncare_medicaid_card_and_tennessee_subrogation_lien_document_memphis.webp","height":768,"width":1376},"url":"https:\/\/www.mamajustice.com\/blog\/what-is-a-tenncare-subrogation-lien-under-tennessee-code-71-5-117\/","about":["Car Accidents"],"wordCount":1788,"keywords":["Car Accidents"],"articleBody":"How Tennessee Medicaid Gets Repaid From Your Car Accident SettlementKey Takeaways: A TennCare subrogation lien under Tennessee Code Annotated \u00a7 71-5-117 is the State’s legal right to be reimbursed from your car accident settlement for medical care TennCare paid after your crash. The statute subrogates the State to your rights against the at-fault party, and accepting benefits creates a deemed assignment by operation of law. "Third party" includes liability insurers, ERISA plans, workers’ compensation, CHAMPUS, and Medicare. Your attorney must notify TennCare before settlement, and if no specific amount is claimed within the statutory window, the interest may be extinguished. The gross lien is reduced to a net subrogation interest based on comparative fault, immune parties, governmental caps, and a pro rata share of attorneys’ fees and costs. Tennessee has displaced the made whole doctrine for these recoveries, and federal law limits Medicaid recovery to the medical-expense portion of a settlement.If TennCare paid for your emergency room visit, imaging, or surgery after a Memphis crash, the State has a legal right to be reimbursed from any money you recover from the at-fault driver. That right is called a TennCare subrogation lien, and it comes from Tennessee Code Annotated \u00a7 71-5-117. The State steps into your shoes for the medical bills it covered, and your settlement generally should not be disbursed without addressing that interest first.If a TennCare lien is complicating your Shelby County injury claim, you do not have to sort out the statute alone. The team at Mama Justice Law Firm handles lien verification and reduction as part of building a car accident case. Call (833) 626-2587 or contact us now to discuss how a Tennessee Medicaid lien may affect your recovery.The Statutory Foundation of a TennCare Subrogation Lien 71-5-117Tennessee Code Annotated \u00a7 71-5-117(a) provides that, to the extent TennCare pays medical assistance, the state is subrogated to the recipient’s rights of recovery against a third party responsible for the injury or illness. The statutory language extends the State’s subrogation to rights of recovery "for the cost of care or treatment for the injury or illness." The Division of TennCare, or a managed care organization acting on its behalf, may assert that interest.There is a second layer as well. Under \u00a7 71-5-117(b), a person who accepts TennCare benefits is deemed to have assigned to the state their rights to third-party insurance benefits. The assignment happens by operation of law, not by signing a separate document, and failure to reimburse the state may affect continued program participation.Why "TennCare" and "Tennessee Medicaid" Mean the Same ThingTennCare is Tennessee’s Medicaid program, so a "Tennessee Medicaid lien" and a TennCare recovery claim describe the same thing. Tennessee Code Annotated \u00a7 71-5-181(b) confirms that "Medicaid program" includes the TennCare program and any successor program.Tennessee Code Annotated \u00a7 71-5-2503 supplies definitions used in the related provisions. An "enrollee" is an individual eligible for and enrolled in the TennCare program, and "benefits" means the health care package of services available to TennCare enrollees. A subrogation lien under \u00a7 71-5-117 typically arises when an enrollee’s crash-related care is paid by the program.The Federal Backdrop: Medicaid as Payer of Last ResortThese liens exist because federal law positions Medicaid behind other available sources of payment. Federal third party liability rules describe the legal obligation of other parties to pay for medical assistance furnished under a Medicaid state plan, and require those parties to meet their obligation before Medicaid pays. Tennessee’s lien statute is the state-level mechanism that enforces that ordering when payment arrives after treatment has already been covered.The authority is layered: 42 U.S.C. \u00a7\u00a7 1396a(a)(25) and 1396k federally, and Tenn. Code Ann. \u00a7 71-5-117 at the state level. Federal law also limits Medicaid’s recovery to the portion of a settlement attributable to medical expenses. Because both frameworks may apply, ignoring a lien is rarely viable.Who Counts as a "Third Party" Under Tennessee Code 71-5-117The statute defines third parties broadly. Under \u00a7 71-5-117(c)(1), a "third party for medical services" can include:Health insurers and liability insurers, including an at-fault driver’s auto carrierERISA plan administrators and employee welfare benefit plansWorkers’ compensation plans, where a crash occurred on the jobCHAMPUS and MedicareBecause the definition sweeps in many payers, a single Memphis car accident lien question can involve overlapping interests. Sorting out priority often requires careful review of plan documents, governing federal law, and the statutory text.The Notice Duty Your Attorney Owes Before Any SettlementPlaintiff’s counsel must affirmatively check for TennCare and MCO subrogation interests before a judgment is entered or a settlement is finalized. Under \u00a7 71-5-117(f), the attorney representing an injured plaintiff is required to contact TennCare and the appropriate managed care organization before that point. The notice is sent by fax or certified mail and typically includes the client’s name, date of birth, Social Security number, TennCare or MCO identification number, and the date the claim arose.The verification process involves submitting TennCare’s subrogation interest inquiry form along with a HIPAA-compliant release. Current forms and submission instructions should be confirmed with the Division of TennCare.Deadlines That Can Extinguish a Subrogation InterestSection 71-5-117(f) sets response deadlines that cut both ways. The lienholder generally has 60 days to respond in writing, and a response stating the total subrogation amount may not exceed 120 days. If no specific amount is claimed within that period, the statute provides that the subrogation interest may be extinguished as to that recovery and disbursement may proceed.This outcome depends on strict compliance with the notice requirements, and courts may scrutinize whether proper notice was actually given. Treating extinguishment as automatic is a mistake. The safer approach is documented, timely notice with proof of delivery.\ud83d\udca1 Pro Tip: Keep the certified mail receipt or fax confirmation in your case file. If a lien claim surfaces months later, that dated proof can be the difference between a resolved claim and a disputed one.How the Gross Lien Shrinks to a Net Subrogation InterestA TennCare lien is rarely paid at face value. Sections 71-5-117(f)(1)-(3), (g), and (h) describe a reduction sequence that can meaningfully increase what an injured person keeps.StepWhat Reduces the LienStatutory Basis1Comparative fault allocated to the plaintiff\u00a7 71-5-117(f)2Fault allocated to immune persons\u00a7 71-5-117(f)3Caps applicable to governmental entities\u00a7 71-5-117(f)4Pro rata share of reasonable attorneys’ fees and litigation costs\u00a7 71-5-117(g)The result is the "net subrogation interest." The plaintiff and attorney are required to promptly remit that amount from the recovery, and if only part of a judgment is collected, the remittance is made pro rata. Because comparative fault is part of the calculation, evidence that strengthens liability in your underlying claim may also reduce what TennCare recovers.The "Made Whole" Doctrine Does Not Apply HereMany injured people assume they must be fully compensated before Medicaid takes anything, but Tennessee law says otherwise for these recoveries. Section 71-5-117(j) contains a legislative intent clause displacing the made whole doctrine for TennCare recoveries, substituting the statutory factors described above. Federal anti-lien principles still apply, however, and limit the State to the medical-expense share of a recovery. The statutory procedures also reach pre-suit settlements, not just cases in litigation.This is where outcomes turn on specific facts. A claim with disputed liability, low policy limits, and significant TennCare payments may resolve very differently from one with clear fault and ample coverage.When Low Policy Limits Collide With a Large LienOne of the hardest scenarios in Shelby County injury claims is a serious injury paid by TennCare against a driver carrying only minimum coverage. When available insurance is smaller than the medical bills, the reduction provisions and any uninsured or underinsured motorist coverage may become central. If you are facing that gap, our discussion of medical bills exceeding insurance limits explains additional options that may apply.\ud83d\udca1 Pro Tip: Do not accept an early adjuster offer before the lien amount is verified. Once funds are disbursed without addressing a valid subrogation interest, unwinding the problem can be far more difficult.Frequently Asked Questions1. Does a TennCare lien apply to my pain and suffering money?The State’s subrogation right under \u00a7 71-5-117 is tied to the cost of care or treatment, and federal law limits Medicaid recovery to the medical-expense portion of a settlement. How that interest is applied against a global settlement is fact-dependent, and the statutory reduction factors in subsections (f) through (h) govern the calculation.2. What happens if I just ignore the lien?Ignoring a valid lien is risky. Accepting benefits creates a deemed assignment to the state under \u00a7 71-5-117(b), failure to reimburse may affect continued program participation, and the State or an MCO may pursue reimbursement directly from the recovery.3. Can a TennCare lien ever go away entirely?Under certain circumstances, it may. If proper notice is given under \u00a7 71-5-117(f) and no specific amount is claimed within the statutory response window, the subrogation interest may be extinguished as to that recovery. Courts examine compliance closely, so this should never be assumed.4. Does an MCO lien work differently from a TennCare lien?Managed care organizations administer benefits for the program, and the statute contemplates contacting both TennCare and the appropriate MCO. The underlying statutory framework is the same, though correspondence and documentation may come from different offices.5. Should I hire counsel just for the lien issue?Lien resolution is handled as part of the overall claim rather than separately. A tenncare subrogation lien 71-5-117 lawyer can address verification, reduction, and remittance while the liability case moves forward.Protecting What You Actually Take HomeA TennCare subrogation lien is not a reason to abandon a claim, but it is a reason to plan carefully from the beginning. The statute gives the State a real reimbursement right, and it also allows injured people meaningful reductions for comparative fault, immune parties, governmental caps, and litigation costs. Whether those reductions apply depends on the facts of your crash and the coverage available.If TennCare covered your treatment after a Memphis collision, get the lien identified before you settle. Reach out to Mama Justice, call (833) 626-2587, or request a free consultation to discuss your options.Disclaimer: This content is for informational purposes only and is not legal advice. Every case is unique, and results may vary. Consult an attorney about your specific circumstances."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Blog","item":"https:\/\/www.mamajustice.com\/blog\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"What Is a TennCare Subrogation Lien Under Tennessee Code 71-5-117?","item":"https:\/\/www.mamajustice.com\/blog\/what-is-a-tenncare-subrogation-lien-under-tennessee-code-71-5-117\/#breadcrumbitem"}]}]