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  • Eleventh Circuit rejects Florida Supreme Court’s interpretation of federal Medicaid statute, rules that Florida Medicaid agency may seek satisfaction of lien from both past and future medical expense components of personal injury settlement
    Eleventh Circuit rejects Florida Supreme Court’s interpretation of federal Medicaid statute, rules that Florida Medicaid agency may seek satisfaction of lien from both past and future medical expense components of personal injury settlement

    On June 26, 2020, in Gallardo v. Mayhew., No. 17-13693, the Eleventh Circuit Court of Appeals ruled that federal Medicaid law does not preempt Florida’s Medicaid ...

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  • Florida Fourth DCA rules that trial court erred in granting defendant’s motion to set off Medicare bill reductions after trial and not reducing PIP set off by premiums paid
    Florida Fourth DCA rules that trial court erred in granting defendant’s motion to set off Medicare bill reductions after trial and not reducing PIP set off by premiums paid

    On June 10, 2020, in Matrisciani v. Garrison Property and Casualty Insurance Company, No. 4D19-406, the Florida Fourth DCA affirmed ...

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  • Florida First DCA affirms Administrative Law Judge reduction of Medicaid lien in personal injury settlement by 91% due to the settlement discount from total damages
    Florida First DCA affirms Administrative Law Judge reduction of Medicaid lien in personal injury settlement by 91% due to the settlement discount from total damages

    On April 17, 2020, in Agency for Health Care Administration v. Rodriguez, No. 1D19-1454, the Florida First DCA affirmed a ALJ’s ...

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  • Florida First DCA reverses Administrative Law Judge’s denial of reduction of Medicaid lien asserted against medical negligence recovery involving a brain damaged infant
    Florida First DCA reverses Administrative Law Judge’s denial of reduction of Medicaid lien asserted against medical negligence recovery involving a brain damaged infant

    On March 12, 2020, in Bryan v. State of Florida, Agency for Health Care Administration (AHCA), No. 1D18-3417, the Florida First DCA reversed an Administrative Law Judge’s denial of a reduction ...

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  • Florida First DCA finds that ALJ erred in rejecting plaintiff’s requested Medicaid lien reduction
    Florida First DCA finds that ALJ erred in rejecting plaintiff’s requested Medicaid lien reduction

    On October 11, 2019, in Larrigui-Negron v. State of Florida, Agency for Health Care Administration, No. 1D18-1172, the Florida First DCA ruled that an Administrative Law Judge (ALJ) ...

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  • Eleventh Circuit Court of Appeals rules assignee of reimbursement claim of Medicare Advantage Organization was barred from suing medical service providers because private Medicare Secondary Payor Act plaintiff can only sue primary plans for reimbursement
    Eleventh Circuit Court of Appeals rules assignee of reimbursement claim of Medicare Advantage Organization was barred from suing medical service providers because private Medicare Secondary Payor Act plaintiff can only sue primary plans for reimbursement

    On March 18, 2019, in MSPA Claims 1, LLC, v. Tenet Florida, Inc. , No. 18-11816, the Eleventh Circuit Court of Appeals affirmed a district court ruling barring a claim to enforce a Medicare Advantage ...

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  • Florida Fifth DCA rules that trial court erred by failing to apply collateral source setoff for Social Security disability payments to personal injury jury verdict
    Florida Fifth DCA rules that trial court erred by failing to apply collateral source setoff for Social Security disability payments to personal injury jury verdict

    On February 2, 2018, in Oswald Woudhuizen and Power Design v. Smith , Case No. 5D17-575, the Florida Fifth DCA ruled that trial court erred by failing to apply a collateral source setoff for Social ...

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  • Eleventh Circuit votes against rehearing en banc regarding its previous 2016 ruling upholding Medicare Advantage Organization's statutory right to double damages against tortfeasor's liability insurer
    Eleventh Circuit votes against rehearing en banc regarding its previous 2016 ruling upholding Medicare Advantage Organization's statutory right to double damages against tortfeasor's liability insurer

    On January 25, 2018, in Humana Medical Plan v. Western Heritage Insurance , No. 15-11436, a majority of the active service judges on the Eleventh Circuit Court of Appeals voted against rehearing en ...

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  • Florida First DCA reduces amount payable to AHCA for Medicaid lien, finds that agency was bound by its stipulation that decedent's parents had right to contest amount of lien
    Florida First DCA reduces amount payable to AHCA for Medicaid lien, finds that agency was bound by its stipulation that decedent's parents had right to contest amount of lien

    On January 26, 2018, in Delgado v. Agency for Health Care Administration , No. 1D16-5768, the Florida First DCA reversed an Administrative Law Judge’s (ALJ) determination that the parents and personal ...

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  • Florida Second DCA rules that Medicaid lien for past medical expenses does not extend to amount of personal injury settlement allocated to future medical expenses
    Florida Second DCA rules that Medicaid lien for past medical expenses does not extend to amount of personal injury settlement allocated to future medical expenses

    On March 10, 2017, in Willoughby v. AHCA , Case No. 2D15-4845, the Florida Second DCA ruled that a Medicaid lien for past medical expenses did not extend to the amount of a personal injury settlement ...

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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
    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 ...

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