§ 8.01-66.9.Lien in favor of Commonwealth, its programs, institutions, or departments on claim for personal injuries.

Section 8.01-66.9 creates the Commonwealth’s own lien, broader and differently structured than the private provider lien in § 8.01-66.2. When an injured person receives treatment paid for through the Virginia Medical Assistance Program, other Department of Medical Assistance Services programs, the Maternal and Child Health Program, or the Children’s Specialty Services Program, or receives care at a hospital or rehabilitation center run by the Commonwealth, the Department for Aging and Rehabilitative Services, or a public institution of higher education, the Commonwealth has a lien for the total amount paid under those programs, and the operating department or institution has a lien for the total amount due for its own services, equipment, or devices — subject to any portion compromised under § 2.2-514. The Commonwealth’s lien reaches funds due the injured person from insurance covering those medical services, including uninsured or underinsured motorist coverage.

The statute then ranks the liens. The lien for amounts paid under the state medical assistance programs outranks the lien for services provided at a Commonwealth-operated facility. Both are inferior to a lien for reasonable attorney’s fees and costs, but superior to every other lien created under this chapter or otherwise — legal fees and costs come off the top of the recovery before any lien is satisfied, and the amount of the Commonwealth’s lien may be compromised under § 2.2-514.

The court in which the injured person’s suit is or may properly be filed can adjust this scheme. On motion or petition by the injured person, personal representative, or attorney, and after written notice to everyone holding a lien on the recovery, the court may reduce the liens and apportion the recovery — whether from a verdict or a negotiated settlement — among the plaintiff, the plaintiff’s attorney, and the Commonwealth or the relevant department or institution, as the equities of the case require. That relief is available only if the injured person, personal representative, or attorney first made a good-faith effort to negotiate a compromise under § 2.2-514, and the court must explain the basis for any reduction in a written order.