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Ross v. Agency for Health Care Administration, 947 So.2d 457 (Fla. Ct. App. 2006)

The wife was a personal representative of the husband’s estate. The husband was killed in a vehicle collision. Medicaid paid $168,691.58 in medical expenses and had an automatic lien. Medicaid filed its lien with the Court alleging a right to full payment. After the wrongful death action was brought, the case settled for $900,000, plus an additional $25,000 on the decedent’s UM policy. The wife then allocated funds among survivors, attorneys, and the agency, giving Medicaid an allocation that paid 25% of its claim. The trial court reallocated the division of the settlement so Medicaid received 50% of its claim. On appeal, the court found that the personal representative does not have the right to make an allocation that deprives Medicaid of less than its full claim. Citing Strafford v. Agency for Health Care Admin., 915 So.2d 643 (Fla. Ct. App. 2005), the trial court makes the allocation and shall order the amount allocated to Medicaid to be paid directly to the agency. The trial court’s allocation of 50% to Medicaid was affirmed.

Note: Fla. Stat. ยง 409.910(11)(f)(1) provides that Medicaid is to be fully reimbursed unless reimbursement would take away more than half of a third-party benefit.

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