States Supports Medicaid Application for Access to Members’ Legal Calculations

On Monday, fourteen states called on the US Supreme Court to allow Medicaid agencies access to any part of members’ legal settlements to pay their medical bills.

V Amicus short The Republican states, led by Ohio and Utah, argued that Medicaid should be able to charge any part of a tort settlement that involves paying for medical services, be it future expenses or past treatment.

The judges are planning hear arguments about this in Januaryand their solution will set the standard for government Medicaid programs across the country.

The case relates to a complaint filed by the parents of Janine Gallardo, who was in a constant vegetative state after being hit by a truck when she got off a school bus in 2008. Gallardo’s parents have sued the truck owner, driver, and the Lee County School Board. and eventually reached a $ 800,000 settlement.

As part of the deal, Gallardo’s parents prevented the Florida Department of Public Health from receiving any settlement money towards her future treatment. But the state’s Medicaid program says it is eligible for $ 300,000 from the deal, including a portion of the compensation reserved for Gallardo’s future medical needs.

In 2017, U.S. District Judge Mark Walker ruled in favor of the parents, stating that the agency should only be able to recover compensation payments related to past medical expenses. The 11th US District Court of Appeals overturned that decision and sided with the FAHCA, ruling that federal Medicaid law requires people to grant the state all of their payment rights before they can receive health care. This rule supports financial support for Medicaid, according to the 11th District.

In another case, the Florida Supreme Court ruled that the FAHCA can only recover settlement funds from past medical expenses.

The states are pushing the court to side with the 11th arrondissement, arguing that federal law takes precedence over state law and that a decision in Gallardo’s favor could lead to Medicaid bankruptcy.

“Reading [the Medicaid Act] otherwise, it would provide an opportunity for parties to resolve disputes over states’ right to recover by labeling all (or nearly all) of the settlement as payment for “future aid,” the amicus note said.

The National Conference of State Legislatures, the National League of Cities, the Public Finance Association and others have also endorsed the Florida Medicaid Agency with a similar agreement.

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