Goheagan v. Perkins, 197 So. 3d 112 (Fla. 4th DCA 2016)
Olive Goheagan, as Personal Representative for the Estate of Molly Swaby (“the Estate”), appealed from a final order which denied the Estate’s motion for equitable distribution, and ordered the Estate to reimburse the Florida Agency for Health Care Administration (“AHCA”) in the full amount of its Medicaid claim. The appellate issue was whether the trial court was wrong by applying section 409.910(11)(f), Florida Statutes (2014), in refusing to reduce the Medicaid claim to an amount equal to the amount recovered by the Estate for past medical expenses. Ultimately, the appellate court held that section 409.910(11)(f) of Florida’s Medicaid Third–Party Liability Act (the “Florida Medicaid Act”)was not preempted by the anti-lien provision of federal Medicaid law in wrongful death actions.
The underlying case: In February 2007 Molly Swaby was severely injured in a car accident after being struck from behind by another driver traveling at a high rate of speed. She suffered a spinal cord injury and was in a coma for approximately three months before passing away in May 2007. Swaby’s medical expenses totaled $970,179.97, of which Medicaid paid $95,476 .60. The Estate brought a wrongful death action against the driver, resulting in a multi-million dollar verdict at trial. After final judgment was entered against the driver, the Estate brought a third-party bad faith claim against the driver’s automobile insurance carrier, eventually settling the case for $1,000,000. AHCA then asserted a lien for $95,476.60 against the settlement proceeds of the bad faith claim based on section 409.910(11)(f), Florida Statutes (responsibility for payments on behalf of Medicaid-eligible persons when other parties are liable), Florida Statutes. Goheagan filed a motion for equitable distribution to reduce the Medicaid claim, arguing that the statute “was preempted by federal law to prevent the state from being reimbursed from monies recovered by a beneficiary for any category of damages other than past medical expenses.” But the trial court ordered the estate to reimburse AHCA in the full amount of its Medicaid claim. The estate appealed, and the issue on appeal was whether the trial court erred by applying section 409.910(11)(f) “in refusing to reduce the Medicaid claim to an amount equal to the amount recovered by the Estate for past medical expenses.” The estate argued that, while section 409.910(11)(f) would permit AHCA to recover the full amount of benefits paid, it was preempted by the anti-lien provision of federal Medicaid law (42 U.S.C. § 1396a), which would allow AHCA to seek reimbursement only “from the non-medical expense portion of a recipient’s recovery.” The trial court held that the reimbursement formula under section 409.910(11)(f), not the anti-lien provision of the federal Medicaid statute, applied in wrongful death cases. It denied the estate’s motion to reduce the lien and ordered it to reimburse AHCA the full amount of its Medicaid lien for benefits it had paid on behalf of the deceased. The appellate court affirmed, noting that the federal Medicaid Act’s anti-lien statute “applies only to living Medicaid recipients.”
Medical Malpractice Attorneys Jacksonville Fl concludes, while Florida’s wrongful death statute allows recovery by survivors and the estate it does not allow Medicaid’s claim to be avoided by a personal representative deciding how to distribute the proceeds.
Read the entire opinion here: http://www.4dca.org/opinions/July%202016/07-20-16/4D14-4843.op.pdf
Source: http://www.flcourts.org/core/fileparse.php/583/urlt/Traffic-Court-Opinions-July-Sept-2016.pdf & http://caselaw.findlaw.com/fl-district-court-of-appeal/1742982.html