Medicaid Liens Limited (Again)
Medicaid's right of reimbursement from tort and worker's compensation settlements and awards was limited again recently. In 2006, the U.S. Supreme Court's decision of Arkansas HHS v Ahlborn, 547 US 268, 126 S Ct 1752 (2006), limited Medicaid's lien to just the portion of an award or settlement that represented money paid for past medical expenses. Congress responded bypassing the 2013 Budget Act that included language that would empower state Medicaid agencies to assert liens against entire settlements or awards, regardless of what those monies represent. Congress, however, repeatedly delayed the effective date of this legislation overturning the Ahlborn decision. Within months of the 2013 legislation finally going into effect, Congress, in §53102 of the Bipartisan Budget Act of 2018, decided to just reinstate the Ahlborn decision as the law of the land. In other words, Medicaid's lien again attaches only to the part of a settlement that represents past medical expenses. Parties to settlements should again be in a better bargaining position negotiating with Medicaid. Medicaid lienholders should find it more difficult to challenge a reasonable proportionate allocation of settlement proceeds to past medical expenses, especially an allocation that has been reviewed and approved by the court.