In Gallardo v. Marstiller (U.S. June 6, 2022 (Google Scholar link)), the U.S. Supreme Court held that a State may seek reimbursement of future medical expenses from injury settlement funds. Prior to Gallardo, the primary cases governing the extent of a State’s right to seek reimbursement for medical assistance (Medicaid) were Arkansas Dep’t of Health […]
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In Cavanaugh v. Geballe (2nd. Cir. 3/17/2022), Cavanaugh, a Connecticut resident, was covered by an Affordable Care Act insurance policy. When his grandmother’s Will was administered, the Department asked the probate court to honor their lien on grandmother’s estate. The probate court held a hearing, after which it determined that fifty percent of Cavanaugh’s distributive […]
A new Medicaid lien case is pending in the U.S. Supreme Court. The question presented is “[w]hether the federal Medicaid Act provides for a state Medicaid program to recover reimbursement for Medicaid’s payment of a beneficiary’s past medical expenses by taking funds from the portion of the beneficiary’s tort recovery that compensates for future medical […]
In Richards v. Georgia Department of Community Health, 278 Ga. 757 (2004), a class of plaintiffs sued DCH contending that O.C.G.A. § 49-4-149 was illegal as applied. The Department’s position was that its claim for reimbursement applied to all funds received by a plaintiff through litigation against responsible third-parties. The plaintiffs argued that DCH’s claim […]
This is a motor vehicle case where Plaintiff cited Ahlborn, seeking to avoid reimbursing Medicaid. Decedent was injured in a collision on June 30, 2005 and died intestate on July 4, 2005 at age 85. A proposed settlement of $50,000 constituted the defendant’s insurance limits. All medical expenses associated with the collision were paid by […]
In Arkansas Dept. Health and Human Services v. Ahlborn, 547 U.S. 268 (2006), Heidi Ahlborn suffered severe and permanent injuries at age 19 as a result of an automobile accident. She was left partially brain damaged and unable to complete her education. Medicaid determined she was eligible for benefits and paid providers $215,645.30 on her behalf. Later, […]
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