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This page last updated in Release Number: 26-03 Release Date: 08/12/2026 Effective Date: 06/01/2026 5.6 Casualty Claim Process (Subrogation) Casualty claims are those claims for BadgerCare Plus benefits resulting from an accident or injury for which a third party may be liable. Example 1 Mike receives treatment for injuries suffered when he was hit by a car. The vehicle owner is the third party and may be responsible for reimbursing BadgerCare Plus for those benefits. If Mike is working with an attorney or insurance agency to settle the claim, he is legally obligated to give notification to the local agency. BadgerCare Plus members should report any casualty claims before the case is settled. The BadgerCare Plus ID number of the BadgerCare Plus member, date of the accident, and the insurance company or name of the attorney to bill should be included with the referral. 5.6.1 Reporting Accident or Injury Claims If members are in an accident or are injured and receive a cash award or settlement due to the accident or injury and Medicaid (including SSI enrollees) pays for part or all of the care, it must be reported. When Medicaid pays for a claim that is related to an accident, a letter is sent to the member informing them of the requirement to report the information. If a member has hired an attorney or is working with an insurance agency to settle the claim, that must also be reported. If a member reports a claim, they must report the accident or injury case to the Casualty Recovery Unit using one of the following methods: Mail: WI Casualty Recovery—HMS 5615 Highpoint Dr., Suite 100
Irving, TX 75038-9984 Telephone: 877-391-7471 Fax: 469-359-4319 Email: wicasualty@hms.com More information can be found at www.wicasualty.com/wi/index.htm. Note If the member is enrolled in an HMO or MCO they must also report the accident or injury to that organization. All other Medicaid members should report in person or via phone their local agency and any HMO or MCO that may have provided services before the case is settled. Members should include the date of the accident and any insurance/attorney information. This page last updated in Release Number: 16-02 Release Date: 08/08/2016 Effective Date: 08/08/2016