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 Florida
Medicaid Casualty Recovery is a Federal Estate Program designed to
recover Medicaid funded medical costs when responsibility rests with
another liable source.
The reason that Medicaid Casualty Recovery Programs
exist is because federal law requires the State of Florida and all
other states to take steps necessary to recover Medicaid funds from
third party sources.
Any time Medicaid has paid and a third party is
identified as responsible for the payment of medical bills, Medicaid
must be reimbursed. This includes almost all types of litigation
including but not limited to auto insurance, liability insurance,
homeowners insurance, settlements from malpractice suits, and even
court ordered restitution from criminal cases.
Under Florida law the Medicaid recipients and-or their
attorneys must inform the Medicaid Program. This is an affirmative
obligation upon all persons involved in Third Party tort litigation if
Medicaid has paid medical benefits.
Failure to notify Medicaid is considered fraud. This
notification must be sent by any recipient of Medicaid benefits and-or
their attorney when it is determined that the third party resources
are, or may be, available. There are many instances where the total
settlement is less than Medicaid's claim. In that case, Medicaid does
not get all the money.
However, there are guidelines related to this
situation. Settlements are subject to a formula to determine the
maximum that Medicaid can recover. If one-half of the settlement after
attorneys fees and taxable costs is less than Medicaid's claim,
Medicaid's recovery is limited to that amount.
Medicaid also has an Estate Recovery Program, which
basically states that when a Medicaid recipient dies, Medicaid may
have a claim against the Estate of the recipient for the total amount
of medical expenditures incurred on behalf of the recipient from age
55 forward, regardless of a liable third party.
For more information about these issues, you may
contact the Agency for Health Care Administration Medicaid Casualty
Recovery Unit and-or Medicaid Estate Recovery Unit at P.O. Box 12900,
Tallahassee, Florida 32317-2900; 850-488-2495 or 800-973-7928.
If you would like further information on this issue or
other issues related to protecting Florida's families, call Brett
Panter at Panter & Panter.
Brett Panter is a partner in the firm of Panter &
Panter, P.A., and is a Board Certified Civil Trial Attorney. The
offices of Panter & Panter, P.A., are located in Pinecrest at 6950
North Kendall Drive at the Panter Building, on the corner of Kendall
and U.S. 1. Brett A. Panter may be be reached for questions or
comments at (305) 662-6178; email at bpanterandpartner.com; or visit
the firm's website wwwpanterandpan
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