Medicaid’s payment of medical bills does not bar recovery from negligent party

When an injured party sues someone who negligently injured him or her, one form of damages the injured party may recover are medical expenses. However, can those expenses be recovered when they have been paid by someone else? In Bennett v. Haley, 132 Ga. App. 512 (1974), the Court said they can be recovered. The question in that case was whether medical and hospital bills paid by Medicaid are recoverable by a plaintiff.

The collateral source rule “permits an injured party to recover damages from a defendant notwithstanding that the plaintiff received compensation from other sources.” Cases showed that “Georgia does not permit a tortfeasor to derive any benefit from a reduction in damages for medical expenses paid by others, whether insurance companies or beneficent boss or helpful relatives.” The Court rejected the Defendant’s argument that the rule was unfair because it subjected him to a potential of paying the same claim twice. “No such statutory legal liability is created in the Medicaid law as to third party liability but there is a directive that “the State or local agency will seek reimbursement for such assistance to the extent of such legal liability.” 42 USCA § 1396a(a) (25).”

As later cases point out, see Ark. HHS v. Ahlborn, 547 U.S. 268 (U.S. 2006) , the State’s right of recovery is against the Medicaid recipient, or rather, the recovery itself. In 2004, the Richards case held that Medicaid has a lien against the entire recovery. Ahlborn, however, made it clear that Medicaid law does not authorize assertion of a lien in excess of the amount paid for medical expenses and that the anti-lien provisions of the Medicaid act prohibits the State from asserting a claim against those portions of the recovery attributable to pain and suffering or lost wages. States are not required to accept a plaintiff’s calculation of the recovery apportioned for medical assistance and may require a hearing. In the recent case of Gallardo v. Marstiller, the Supreme Court held that a State may seek reimbursement of future medical expenses from injury settlement funds.