Casualty TPL subrogation is responsible for collecting funds paid out by Vermont Medicaid when another party is found responsible for payment, such as, a property insurance, auto insurance, workers compensation insurance, or another responsible party.
Please complete the New Request Form below for each individual Medicaid member and specific incident. The information contained is required for us to complete the lien and notify the correct parties.
- New Request Form (Attorney's NOTE: HIPAA mandates that DVHA also must receive a copy of your client's signed Medical Release Authorization Form.)