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AI-Assisted Medicaid Lien Identification for Injury Cases

Accountable
Department of Social Services (DSS)
Functional Modes
Deciding (Analytical AI)
Human decides
Purpose
Risk Assessment & Triage
Input Dataset
Sensitive personal information Identifiable data
Algorithm or Model
Classification & Prediction
Output Dataset
A decision about you Identifiable data

This system uses machine learning to review Medicaid medical records and flag which healthcare encounters are related to a personal injury for which a client received lawsuit funds. The New York City Department of Social Services uses these results to determine whether to place a lien to recover Medicaid costs. A DSS staff member reviews every output before any notice is sent to a client or their attorney.

Sources for this disclosure

This disclosure was drafted with AI assistance.

Schema: ai@2026-05-06-beta