Medicaid Claims Against Personal Injury Suits
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A recent Blog we posted reported on a recent U.S. Supreme Court case regarding Medicaid claims against personal injury settlements:
U.S. Supreme Court Restricts Medicaid’s Right to Put a Lien Against Personal Injury Settlement
When someone receiving Medicaid settles or wins a personal injury lawsuit, a portion of the award is for medical expenses and usually there is a portion for pain and suffering along with possible punitive damages.
The U.S. Supreme Court in a case decided a few years ago held that the Medicaid Agency has the right to be reimbursed for expenses it paid on the injured person, but solely from the portion of the award allocated to medical expenses. Any funds remaining after the Medicaid reimbursement has been satisfied can be transferred to a Supplemental Needs Trust.
A Supplemental Needs Trust allows the injured person to remain covered by Medicaid and the funds in the Trust can be used to pay for any expenses not covered by Medicaid so that the quality of life of the injured person can be enhanced.
The State of North Carolina had a statute that made one-third of all personal injury awards automatically be deemed to be for medical expenses and recoverable by Medicaid for expenses it paid out. In a recent case, the U.S. Supreme Court struck down this statute and held that each case is unique and there must either be an agreement among the parties or a judicial determination of the portion of the injury award that is to be allocated for reimbursement of medical expenses.
These two Supreme Court cases show that it is critical that parties to a personal injury case where Medicaid is involved need to be mindful that the Medicaid Agency is entitled to reimbursement from the medical portion of the settlement award and therefore when negotiating a settlement, there should be discussion on how the settlement is to be allocated between medical and pain and suffering and also there should be a discussion on the advisability of establishing a Supplemental Needs Trust.
The Koldin Law Center, P.C. has been retained by many personal injury attorneys to prepare Supplemental Needs Trusts for their clients.
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