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U.S. Supreme Court to weigh Florida Medicaid fight tied to Lee County case



U.S. Supreme Court to weigh Florida Medicaid fight tied to Lee County case


The U.S. Supreme CourtIt is on the horizon toYou can have a disagreement about the amount of money Florida’s MedicaidProgramm should be usable toAfter a court settlement, you can recoup your losses. Lee CountyAfter getting off the school bus, a girl sustained catastrophic injuries.

It caseThe justices will hear the matter Jan. 10 and it has attracted attention of officials from across the nation.

U.S. Department of Justice stood by Gianinna Gallardo’s parents, who were left with what attorneys called a “distressed state”. “persistent vegetative state”The accident was averted. Currently, the accident has been supported by 14 states as well as groups like the National Conference of State Legislatures. Florida Agency for Health Care Administration, which runs the state’s Medicaid program.

It casefocuses on the amount of money that is being spent MedicaidProgramm should be usable to recover after it paid $862,688 for Gallardo’s medical care after the accident, which happened when she was 13.

Gallardo’s parents filed a lawsuit against the truck’s owner and driver and the Lee CountyFinal settlement reached by the School Board was $800,000.

According to a formula found in state law the Agency for Health Care Administration declared it entitled toThe settlement allowed the plaintiff to recover $300,000. It also included the money that was allocated to future and past medical costs.

However, Gallardo lawyers claim that MedicaidProgramm should not be limited to being able to recover money for past medical costs that it paid — not from the portion of the settlement for future medical expenses.

The parents were notified by a U.S. District Judge who agreed to their request. However, the U.S. 11th U.S. Circuit CourtAppeal overturned the decision and ruled in favor of state.

In a September brief, the parents’ attorneys wrote that “third-party”Provisions in Federal Law “give a state no right to payments for medical expenses Medicaid has not paid.”

“In this case, Florida paid for petitioner’s past medical expenses, but not for her future medical expenses,”Another September brief was submitted by Justice Department lawyers. “The third-party-liability provisions thus entitle Florida only to the portion of petitioner’s tort settlement that represents past medical expenses. Yet Florida has imposed a lien even against the portion that represents future medical expenses.”

In a briefing, attorneys representing the state said that the $35,367 settlement had been allocated only for medical expenses in the past. Federal law permits the state to recover a part of the settlement that was designated for future medical expenses.

“Because health care is expensive, when a person suffers a sudden and acute injury, Medicaid often steps up to cover the medical costs,” the state’s brief said. “At the same time, Congress has made Medicaid the payer of last resort, meaning that other sources available to pay medical expenses must be exhausted before Medicaid pays for care. Consistent with that structure, state Medicaid programs must recover their costs from third parties who owe payments for medical care to the beneficiary.”

Additional briefs FloridaAlso pointed toPotential implications of a decision against the state

“In sum, petitioner is requesting that the (Supreme) Court further limit the available payments that the state is entitled to reach,”According to a brief submitted last month by National Conference of State Legislatures. The National League of Cities and the U.S. Conference of Mayors filed the brief. “Petitioner’s reading is contrary to both the statutory text and the intent of Congress, and would severely limit the state’s ability to recover its Medicaid expenditures.”

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