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Florida First DCA rules that personal injury plaintiff waived his right to contest amount of Medicaid lien by failing to file DOAH petition by statutory deadline of 21 days from deposit of lien amount in an interest-bearing trust account for the benefit of AHCA

On May 17, 2021, in Mathers v. Agency for Health Care Administration, No. 1D19-4407, the Florida First DCA affirmed a decision by an Administrative Law Judge (ALJ) dismissing as untimely the petition by a personal injury plaintiff challenging the amount of the Medicaid lien on his settlement. The parties in the personal injury case had reached a confidential settlement and in February 2016 the proceeds from the settlement were deposited in an interest-bearing trust account for the benefit of AHCA, which had asserted a lien for the full amount of benefits paid related to the plaintiff’s injuries from the accident. More than three years later, in 2019, the plaintiff filed a petition with the Division of Administrative Hearings (“DOAH”) contesting the amount that AHCA could recover from his personal injury settlement to satisfy its lien. The ALJ dismissed the petition as untimely because the plaintiff did not file it within 21 days after he placed his settlement proceeds in an interest-bearing trust account for the benefit of Medicaid, as required by section 409.910(17)(b), Florida Statutes (2015). The First DCA agreed, noting that under the plain language of the statute, the 21-day time frame for contesting the formula-based allocation was triggered when the plaintiff placed his settlement proceeds in trust for the benefit of AHCA. The Court cited Holly v. Auld, 450 So. 2d 217, 219 (Fla. 1984) (“[C]ourts of this state are without power to construe an unambiguous statute in a way which would extend, modify, or limit, its express terms or its reasonable and obvious implications.”) (quoting Am. Bankers Life Assurance Co. of Fla. v. Williams, 212 So. 2d 777, 778 (Fla. 1st DCA 1968)).

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