The negligence of a medical professional can sometimes lead to pain and suffering as well as unexpected medical costs. Medical malpractice awards are normally given as a form of compensation that seeks to offset past, present and future costs associated with the incident. How much of the award Medicaid beneficiaries can keep is now under discussion as part of a case before the U.S. Supreme Court.
Readers in Miami may be interested in hearing about the matter. It involves a $2.8 million settlement award to a couple whose daughter was the victim of the negligence of a doctor. The 12-year-old child was injured during birth and cannot hear, see, sit, crawl or converse.
It is estimated that the state has paid more than $1.9 million in Medicaid funds to provide medical care for the girl. As such, the state claims it is entitled to one-third of the medical malpractice award, some $933,000, in accordance with state law allowing state reimbursement in cases of malpractice awards.
The move by the state of North Carolina was challenged by the couple, who argues that it conflicts with federal law. Under federal law, medical malpractice settlements are considered property. Governments are prohibited by the Medicaid law from placing liens on Medicaid patients' property.
The issue here is over the accounting of the award amount. The Supreme Court has previously ruled that only parts of malpractice settlements, such as for pain and suffering, are protected as property from state lien. The ban on liens does not extend to payments for medical care. But the $2.8 million settlement in this case didn't get designated according to care costs and pain and suffering.
States who have offered briefs in the case say they are fearful that Medicaid beneficiaries could seek to categorize all such settlements in the future as pain and suffering in an attempt to block state claims on reimbursements.
Individuals who have suffered at the hands of negligent professionals in Florida should know their rights and hold them accountable for their actions. But as this case shows, who pays for the resulting care also needs to be taken into consideration.
A final decision isn't likely to come for some months. Meanwhile, the parents of the 12-year-old girl in this case must wait to see how much of their settlement they will be allowed to keep.
Source: The Miami Herald, "Supreme Court case involves medical malpractice awards, Medicaid," Michael Doyle, Jan. 7, 2013