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Have Federal Amendments Really Changed The Ahlborn Decision?

If you have followed the caselaw interpreting Ahlborn you know that it has been a long winding road with many attempts by state Medicaid agencies to access the entire settlement, not just the portion attributed to medical expenses. Most recently in 2013 Congress sought to strengthen the Medicaid third-party liability act when it passed the Bipartisan Budget Act of 2013. In section 202(b) Congress made it mandatory that states seek any payment from a third party – not just payment for medical care. This law was set to become effective on October 1, 2014. It is delayed until October 1, 2016 (see HR 4302 Sec. 211).

In the interim you want to read Harrell v. AHCA, 143 So.3d 478 (Fla. 1st DCA 2014). The Court held that a plaintiff must be given the opportunity to rebut the statutory presumption of F.S. 409.910(11)(f) through an evidentiary hearing to show that the lien exceeds the amount recovered for medical expenses. The primary basis for the appellate court’s ruling was that the U.S. Supreme Court had decided Wos v. E.M.A. U.S. (2013) in the interim holding that a state’s statutory scheme for calculating the Medicaid lien was pre-empted by the federal Anti-Lien law to the extent it seeks payment from non-medical.

In the 2013 Florida legislative session F.S. 409.910(17)(b)-(e) was amended to provide a procedure for filing a petition with the Division of Administrative Hearings.

Don’t wait until you have a crisis to call our office at 954-382-1997 to schedule a consultation. Let us counsel you and your clients about their options. We’ll have time to implement a plan together so you and your clients have peace of mind.