Department of Human Services | Third Party Liability

The Division of Medical Assistance and Health Services (DMAHS), Office of Legal and Regulatory Affairs’ Recovery Units recover money from legally responsible third parties when DMAHS has paid claims on behalf of a Medicaid/NJ FamilyCare beneficiary. These circumstances commonly include when the beneficiary receives a payment, award or settlement from an auto, homeowner’s, workers’ compensation, or malpractice insurance carrier intended to compensate the beneficiary for an injury. These circumstances also include product liability recoveries and recoveries for other catastrophic injuries. DMAHS is required by the State statutes appearing below, and by federal law, to take all reasonable measures to identify liable parties and to seek reimbursement.

By law, an individual or their representative must provide DMAHS with written notice upon filing a claim or action against a third party, and by law, the individual or their representative must immediately reimburse DMAHS from any recovery for that claim or action.

N.J.S.A. 30:4D-7.1 states:

. . . b. When a recipient, his guardian, executor, administrator or other appropriate representative brings an action for damages against a third party, written notice shall be given to the Director of the Division of Medical Assistance and Health Services. In addition, every recipient or his legal representative shall promptly notify the division of any recovery from a third party and shall immediately reimburse the division in full from the proceeds of any settlement, judgment, or other recovery in any action or claim initiated against any such third party subject to a pro rata deduction for counsel fees, costs, or other expenses incurred by the recipient or the recipient’s attorney; provided, however, that the director may make application to a court of competent jurisdiction for an award of counsel fees and costs incurred in the pursuit of a claim under this subsection. . .

New Jersey Medicaid/NJ FamilyCare Tort and Casualty Insurance Recoveries are made by the following Entities:

1. DMAHS Office of Legal and Regulatory Affairs, Recovery Units:

For medical malpractice cases, catastrophic injuries, and for tort matters that become estates cases,

Notice - notice of the case/action must be provided to:

Division of Medical Assistance & Health Services
Office of Legal & Regulatory Affairs
PO Box 712, #6
Trenton, NJ 08625-0712
FAX: 609-588-7343

For questions about a DMAHS recovery matter, please call 609-588-3016

All payments to DMAHS’ Recovery Units should be mailed to one of the following addresses:

By regular mail:
NJ Division of Revenue
Lockbox 656
200 Woolverton Ave., Bldg. 20
Trenton, NJ 08646

By Overnight Mail, Certified Mail, FedEx or Courier:
NJ Division of Revenue
200 Woolverton Ave., Bldg. 20
Lockbox 656
Trenton, NJ 08646
Attn: Processing Bureau.

Checks should be made payable to “Treasurer, State of New Jersey”

2. DMAHS’s Contractor, Health Management Systems (HMS):

For motor vehicle accidents, dog bites, nursing home injuries, product liability, mass torts, class actions, workers’ compensation matters,

Notice of the case can be provided to:

Health Management System
NJ Trauma and Tort Recovery Project
1 Quakerbridge Plaza, Suite 3
Mercerville, NJ 08619
FAX: 866-276-1176

Questions - For questions about an HMS recovery matter see the “Contact” page at http://hms.com/us/new-jersey/home/.

Additional communication with HMS - Once a case is established with HMS, an attorney or insurance company can use the six digit HMS case number to submit additional case information and make requests for case information, including final claim amounts, at the following website: https://submissions.hms.com.

✓ IDocs (Internet Document Submissions) – for submitting case documents

✓ CRUISE (Claim Request Update Inquiry Service Enterprise) – for requesting claim amounts (initial, interim, final)

✓ SOLARIS (Subrogation On-Line Attorney Referral Information Service): for case creation

All payments to HMS should be mailed to:

By Regular Mail
New Jersey Division of Medical Assistance & Health Services
P.O. Box 416522
Boston, MA 02241-6522

By Overnight or Express Mailing
Bank of America Lockbox Services
NJ DMAHS 416522
MA5-527-02-07
2 Morrissey Blvd.
Dorchester, MA 02125-6522

Checks should be made payable to “Treasurer, State of New Jersey”