If someone is receiving Medicaid and was injured through the negligence of others, Medicaid asserts a third-party claim against any recovery, whether by settlement or verdict. This is sometimes known as a Medicaid lien. The form shown below is one currently used by Georgia Medicaid when investigating whether a third-party claim exists.
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In Gallardo v. Marstiller (U.S. June 6, 2022 (Google Scholar link)), the U.S. Supreme Court held that a State may seek reimbursement of future medical expenses from injury settlement funds. Prior to Gallardo, the primary cases governing the extent of a State’s right to seek reimbursement for medical assistance (Medicaid) were Arkansas Dep’t of Health […]
In Cavanaugh v. Geballe (2nd. Cir. 3/17/2022), Cavanaugh, a Connecticut resident, was covered by an Affordable Care Act insurance policy. When his grandmother’s Will was administered, the Department asked the probate court to honor their lien on grandmother’s estate. The probate court held a hearing, after which it determined that fifty percent of Cavanaugh’s distributive […]
A new Medicaid lien case is pending in the U.S. Supreme Court. The question presented is “[w]hether the federal Medicaid Act provides for a state Medicaid program to recover reimbursement for Medicaid’s payment of a beneficiary’s past medical expenses by taking funds from the portion of the beneficiary’s tort recovery that compensates for future medical […]
In Richards v. Georgia Department of Community Health, 278 Ga. 757 (2004), a class of plaintiffs sued DCH contending that O.C.G.A. § 49-4-149 was illegal as applied. The Department’s position was that its claim for reimbursement applied to all funds received by a plaintiff through litigation against responsible third-parties. The plaintiffs argued that DCH’s claim […]
