The US to Argue Against Florida in Medicaid Lien Case at Supreme Court

The Supreme Court Grants the United States’ Motion to Participate in Oral Arguments in Medicaid Third Party Liability Liens Case, Will Argue in Favor of Gallardo, Against Florida

As the country’s only national law firm with a focus on Medicare and Medicaid secondary payer compliance, one of our goals is to keep all of our current and potential clients updated on the latest news and events regarding Medicare and Medicaid. Whether state or federal statutory amendments, regulatory changes, administrative proposals, or case law, our intent is to keep you abreast of the most important and significant items happening in the Medicare and Medicaid space. We believe?Gallardo v. Marstiller?is one of those cases, one of those events.?

As we have communicated previously, oral argument is set for Monday, January 10, 2022 on this case.?During and while oral arguments are being delivered and discussed, Cattie & Gonzalez?will provide live updates on our LinkedIn and Twitter pages.?After oral arguments, we will summarize remarks, questions, and comments made by the parties and the justices. And, after a decision is made by the court, we will break it down for you and provide you with an explanation of what it means to plaintiffs and defendants involved in litigation with Medicaid recipients.

We have written several blogs on this case. In our first blog, we provided details of the case and its history. In our?second blog, we provided an analysis of the arguments made by both parties in their briefs to the court. In our?third blog, we provided a review of each of the amicus briefs filed with the court by the various groups, organizations, and governmental entities with an interest in the outcome of the case. Today, we provide a significant update, as the Court has granted the United States’ motion to participate in oral arguments as amicus curiae.

Court Grants United States’ Motion to Participate in Oral Arguments

On November 18, 2021, the United States filed a?motion?for leave to participate in oral argument as amicus curiae, for enlargement of time for oral argument, and for divided argument. Pursuant to Rule 28 of the Rules of the United States Supreme Court, the Solicitor General, on behalf of the United States, filed a motion that the United States be granted leave to participate in the oral argument in this case, that the time for oral argument be enlarged to 70 minutes, and that the time be allotted as follows: 20 minutes for petitioner (Gallardo), 15 minutes for the United States, and 35 minutes for respondent (Marstiller). Perhaps because petitioner and respondent both consented to the US motion, the Court granted the US motion on December 6, 2021.

The United States Amicus Curiae Brief

In its motion, the US indicated that this case presents the question whether the Medicaid Act’s third-party-liability provisions permit a State to recover reimbursement for medical expenses paid by Medicaid by obtaining a portion of the recipient’s tort recovery that represents medical expenses not paid by Medicaid. As we outlined in our third blog, the United States filed a?brief?as amicus curiae supporting petitioner, arguing that the Medicaid Act permits a State to recover only the portion of the recipient’s tort recovery that represents expenses paid by Medicaid. In its amicus brief, the US argued that a?State may impose a lien only on the portions of a recipient’s recovery that represent compensation for medical expenses paid by Medicaid.?

In its amicus brief, the United States argued that?the anti-lien clause of the Medicaid law bars liens against a recipient’s settlement or judgment, except as authorized by the third-party-liability provisions. Although States retain broad discretion to establish procedures for allocating settlements, the US further argued that the third-party-liability provisions of the Act entitle States only to the portions of a recovery that represent medical expenses already paid by Medicaid. Hence, the United States made it clear in its amicus brief that contrary interpretations lack merit; meaning the court of appeals’ interpretation is incorrect and Florida’s interpretation is incorrect.

The United States Has a Substantial Interest in This Issue and Case

In its motion, the United States points out that it has a substantial interest in this case. The Medicaid Act’s third-party-liability provisions provide a source of compensation for Medicaid at both the federal and state levels. Under those provisions, the United States is entitled to a portion of any third-party recovery obtained by the State. See 42 U.S.C. 1396k(b). In addition, Congress has vested the Secretary of Health and Human Services with broad authority to administer Medicaid. See 42 U.S.C. 1302. Therefore, the question presented involves the Secretary’s interpretation and implementation of the statute, which necessitates the United States to be allowed to participate in oral arguments.

This is not the first time the United States has asked for permission to be a part of oral arguments in a Medicaid case in which the US is not a party. The United States has previously presented argument as an amicus curiae in two other cases involving the Medicaid Act’s third-party-liability provisions:?Wos v. E.M.A. ex rel. Johnson, 568 U.S. 627 (2013) (No. 12-98), and?Arkansas Department of Health and Human Services v. Ahlborn, 547 U.S. 268 (2006) (No. 04-1506).?As was the case in both of those matters, and is the case here,?the United States argued in its motion that its participation in oral argument could materially assist the Court in its consideration of the case, the law, the regulations, the interpretation of policies and procedures, as well as administrative guidance and regulatory deference.

Conclusion

With over 81 million Americans receiving Medicaid benefits today, costing us close to $700 billion, this decision stands to effect 25% of our country’s population, and immediately become one of the most significant cases to be decided by the United States Supreme Court regarding individuals receiving Medicaid benefits and also involved in class action, medical malpractice, no-fault, nursing home, personal injury, products liability, workers compensation, and wrongful death litigation.?

On Monday, January 10, 2022, during and while oral arguments are being delivered and discussed, Cattie & Gonzalez will provide live updates on our LinkedIn?and?Twitter?pages. After oral arguments, we will summarize remarks, questions, and comments made by the parties and the justices. And after a decision is made by the court, we will break it down for you and provide you with an explanation of what it means to plaintiffs and defendants involved in litigation with Medicaid recipients. To stay informed and updated, you may also visit us at?www.cattielaw.com, and sign up for our blog and newsletter.

About Rafael Gonzalez, Esq.

Rafael is a partner in?Cattie & Gonzalez, PLLC,?a national law firm focusing its practice on federal Medicare/Medicaid secondary payer compliance and legal issues. In addition to assisting clients with Medicare mandatory reporting, conditional payments, and set asides issues, he helps clients with Medicaid third party liability liens and Medicaid special needs trusts issues. He has over 35 years experience in?the liability, no-fault,?and work comp insurance industry.?You can connect with him on?LinkedIn,?Twitter,?Facebook,?Instagramand?YouTube, or reach him at [email protected] or 844.546.3500.