Supreme Court's Medicaid clawback ruling could mean less money for state programs, critics say

Critics of a June 6 U.S. Supreme Court ruling involving Medicaid clawbacks from personal injury litigation wins say the decision could result in less money for state Medicaid programs, Bloomberg reported June 10. 

The court ruled that states can seek reimbursements for future medical care from Medicaid beneficiaries who win money in personal injury litigation. Plaintiffs in the case argued states can only tap into the money for past expenses. Seven of the court's nine judges disagreed, however. Justice Clarence Thomas, who wrote the court's majority opinion, said the Medicaid Act distinguishes "only between medical and nonmedical care, not between past (paid) medical care payments and future (unpaid) medical care payments."

Stanford Law professor Nora Engstrom told Bloomberg the decision "absolutely will reduce litigants' incentives to bring personal injury lawsuits." 

Paul Cannon, a shareholder with Houston-based personal injury firm Simmons Fletcher PC, told Bloomberg the decision could be "devastating for plaintiffs in small-dollar personal injury cases."

"If I'm looking at a case with a maximum recovery of $10,000 or $20,000, there isn't very much money available after you've paid the expenses and subtracted the state's share for medical expenses that have already been paid," he told Bloomberg. "And now if the state comes in to take from the money for future medical (costs), there's even less. A lot of these cases will never be brought."

Discouraging Medicaid-involved lawsuits could mean less money flowing into state Medicaid programs, Mr. Cannon said. 

"They could pay dearly for the larger share of a shrinking pie," he said. 

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