SCOTUS decision lets Florida recover future Medicaid costs from injured patient’s settlement
Clarence Thomas wants to revisit same-sex marriage, throwing Congressional Democrats — and some Republicans — into panic mode.

'The plain text of (the Medicaid Act) decides this case,' Justice Clarence Thomas wrote in the 7-2 decision.

Florida can recover money from a settlement award won by an injured Medicaid patient, the U.S. Supreme Court ruled Monday.

The 7-2 decision written by Justice Clarence Thomas ruled the federal Medicaid Act allows states to recover settlement awards for future medical expenses. Although the federal law prohibits states from placing a lien on a patient’s “property,” there is an exemption for settlements involving awards for medical expenses. Thomas rebutted arguments that the exemption only applies to damages for past medical expenses, not for future medical expenses.

“The plain text of (the Medicaid Act) decides this case,” Thomas wrote. “Nothing in this provision purports to limit a beneficiary’s assignment to ‘payment for’ past ‘medical care’ already paid for by Medicaid.”

Justice Sonia Sotomayor wrote a dissent, backed by Justice Stephen Breyer, arguing the majority ruling unfairly allows states to receive money for future expenses that might not be covered by Medicaid.

“The Court’s holding is inconsistent with the structure of the Medicaid program and will cause needless unfairness and disruption,” Sotomayor wrote.

The case centered on a Lee County student, Gianinna Gallardo, who was 13 in 2008 when she was hit by a truck as she exited a school bus. She endured catastrophic injuries and is permanently disabled. Florida’s Agency for Health Care Administration, which runs the state’s Medicaid program, paid $862,688.77 for Gallardo’s initial medical care after the incident and continues to pay for her medical expenses.

Gallardo’s parents sued the truck’s owner and driver, and the Lee County School Board, winning a settlement of $800,000, with $35,367.52 expressly for prior medical expenses. AHCA put a lien on Gallardo’s settlement award for $300,000, or 37.5% of the award, according to state law allowing the state to recover benefits from liable third parties.

AHCA routinely recovers settlement awards to pay for Medicaid expenses and the opinion confirms its practices surrounding Medicaid settlement liens.

“The Agency feels the Supreme Court opinion speaks for itself,” AHCA spokeswoman Kayla McLaughlin wrote in an email.

Gallardo’s family sued Florida, arguing the federal Medicaid Act prohibits the state from recovering money from a settlement intended to pay for future medical expenses to pay for past medical expenses. A district court sided with Gallardo, but the 11th Circuit Court of Appeals reversed the decision. Monday’s ruling upheld the appellate decision.

Gray Rohrer


  • Charles Jones

    June 6, 2022 at 1:11 pm

    An odd ruling supporting these government programs that the GOP has vowed to eliminate.

    • 2x

      June 6, 2022 at 1:36 pm

      That’s because the gop is worse then devil.

  • Kris

    June 6, 2022 at 6:34 pm

    And this is how all the corporations and anyone else they deem worthy will get rich from you. It contradicts the ruling and intent, but corrupt Clarence will always side away from the right thing to do for the public

  • Therese

    June 7, 2022 at 8:27 am

    Please Florida, Vote blue across the ticket.

  • It's Complicated

    June 7, 2022 at 1:22 pm

    I am having trouble understanding why people object to the state recouping these funds. Ms. Gallardo’s medical care has been funded by FL Medicaid since the accident, which occurred when she was 13-years old – is still being paid for by Medicaid, and will continue to be paid by Medicaid until her death. The lien upon the award is statutory.

    If we had a Democrat in the Governor’s mansion, none of these naysayers would give a flip about this case. Just another thing to ‘blame’ on a Republican. It is a tired song.

    • Robert Mazzi

      June 7, 2022 at 1:55 pm

      That assumes that Medicaid will continue to pay for her care.

      I’d also say that it opens the door to reopening the case as the amount awarded is now no longer guaranteed to be available for future care of this person. And, the school board was one of the parties to the suit.

  • Linda Rodriguez

    June 7, 2022 at 5:03 pm

    What would happen if the disabled individual died next week and there were no future medical costs to Medicaid? Would her parents have the right to the remaining money, as her beneficiary, or would Medicaid get to keep that unspent $800,000?

Comments are closed.


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