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Supreme Court to Consider How Much States Can Reclaim from Medicaid Patients’ Medical Malpractice Awards

Written by Ankin Law Office

The U.S. Supreme Court is considering a case that could have a serious impact on the amount a plaintiff can recover in a medical malpractice case. According to this article, the plaintiff in the case is a teenager who is seriously disabled as a result of a birth injury. At issue is whether North Carolina (and other states, for that matter) can reclaim some of the Medicaid funds that it spent on the plaintiff’s medical care. Under North Carolina law, the state is allowed to reclaim the amount it spent on the plaintiff’s medical expenses or one-third of a medical malpractice settlement or judgment that is awarded to a Medicaid patient, whichever is less.

The plaintiff alleges that North Carolina’s automatic one-third share is excessive, and that Medicaid reclamations should be determined after individual hearings on the facts of the case.

After obstetrical negligence caused the plaintiff’s cerebral palsy, the plaintiff’s parents sued the obstetrician, the medical center and others, and were awarded $2.8 million in damages. The settlement did not specify how much was attributed to medical expenses and how much was attributed to other factors.

North Carolina subsequently asserted a lien on $933,333.33 of the damages award based on the one-third law, estimating that it spent more than $1.9 million in Medicaid funds providing medical care for the plaintiff.

During oral arguments, Justice Stephen Breyer said that “the question here is how to figure” a patient’s medical expenses. Justice Antonin Scalia expressed doubts about determining which amount is subject to a state claim, saying “I don’t know how you go about determining how much of a settlement is attributable to medical expenses.”  Justice Scalia also seemed skeptical of the inefficiency that might result if an individual hearing was required to determine the amount of a medical malpractice award that was attributable to medical expenses.

Justice Elena Kagan acknowledged that “the advantage of bright-line rules is [that] they are cheap and effective, but she also asked many pointed questions about whether North Carolina’s one-third rule was arbitrary.

The Court’s decision is expected in June.

In general, plaintiffs in medical malpractice cases may be entitled to recover compensation for:

  • Past and future medical expenses
  • Lost wages
  • Loss of future income
  • Household services
  • Pain and suffering
  • Loss of enjoyment of life
  • Permanent disability
  • Disfigurement

At Ankin Law Offices, LLC, our Chicago medical malpractice attorneys are committed to protecting the rights of the victims of medical malpractice and their families. We seek to recover maximum compensation. If you or a loved one has been the victim of medical malpractice, contact our office at (312) 600-0000 to schedule a free consultation with one of our Chicago medical malpractice attorneys.

Categories: Medical Malpractice