Medicaid Lien Reduction.

• Author: Joyce, Kevin
• Position: LETTERS - Letter to the editor

"Medicaid Lien Reduction: Is it Possible?" by Gerald and Brian Schackow (Feb. 2015) is a misguided attempt to navigate the world of Medicaid liens and F.S. [section] 409.910, so I write to provide a corrected map.

First, the article states that "[w]hen settlement finds are less than the Medicaid lien, then and only then, a formula to reduce the Medicaid lien found in [section]409.910(11)(f) permits the plaintiff the right to split the settlement proceeds with Medicaid...." This statement is simply incorrect. Section 409.910(11)(f) applies whether settlement funds are less than the Medicaid lien or not. A careful reading of the statute shows that even when the settlement amount exceeds the lien, a reduction is possible. To illustrate, a lien of $50,000 would be reduced to $22,500 on a settlement of $60,000, based on the formula (assuming there were no taxable costs).

Another flaw is the idea that Medicaid is limited to a recovery for only past medical expenses. To evidence this incorrect idea, the authors provide Arkansas Department of Health & Human Services v. Ahlborn, 547 U.S. 268 (2006), and Wos v. E.M.A., 133 S. Ct. 1391 (2013), and several Florida cases. However, the true holdings in these cases are overlooked. The U.S. Supreme Court in Ahlborn held recovery cannot be for payments "for anything other than medical expenses." There is no limitation to past medical expenses. Further, in Wos, the U.S. Supreme Court held that an irrebuttable statutory presumption is not valid and that a recipient must have the opportunity to prove the formula amount exceeds the medical expense portion of a settlement. Again, there is no limitation to past medical expenses. To further this point, Wos made reference to "medical expenses," "medical payments," or "medical damages"...