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First District Court of Appeal rules that Medicaid lien for past medical expenses extends to amount of personal injury settlement allocated to both past and future medical expenses

On December 12, 2016, in Estate of Villa v. AHCA, 41 Fla. L. Weekly D2743 (Fla. 1st DCA Dec. 12, 2016), the Florida First District Court of Appeal ruled that the plaintiff failed to provide clear and convincing evidence to support a Medicaid lien reduction from the normal statutory cap (50% of the total settlement proceeds after deducting attorneys' fees and costs) to a substantially lower amount allocated to past medical expenses in the settlement agreement with the defendant. In ruling in favor of the AHCA, the Court noted that Florida Statute Section 409.910(17)(b), which authorizes a Medicaid recipient to challenge an AHCA demand, expressly requires consideration of both past and future medical expenses, and the Court found that this requirement is not in conflict with the U.S. Supreme Court's ruling in Arkansas Department of Health & Human Services v. Ahlborn, 547 U.S. 268, 282 (2006) that a state Medicaid provider could not recover more than the total amount of a judgment or settlement allocated to medical expenses.

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