Gallardo v. Marstiller
Issues
Under the federal Medicaid Act, does a Medicaid program have authority to recover reimbursement for its payment of a beneficiary’s medical expenses by taking funds from a legal recovery which compensates for future medical expenses for that beneficiary?
This case asks the Supreme Court to determine whether, pursuant to the federal Medicaid Act, a state Medicaid program may recover reimbursement for its payment of a beneficiary’s past medical expenses by allocating funds from a portion of the participant’s settlement that compensates for future medical expenses. Florida law requires Medicaid beneficiaries to assign any rights to reimbursement for medical care from third parties to the state. In this case, Gianinna Gallardo contends that a state cannot collect reimbursement for future medical expenses from a Medicaid beneficiary’s settlement against a third party. In response, Simone Marstiller, Secretary of the Florida Agency for Health Care Administration, counters that the state may recover reimbursement for both past and future medical expenses because the Florida statute does not explicitly bar recovery for future medical care. The outcome of this case will affect how the burden of Medicaid costs is allocated between individuals and the state and federal governments.
Questions as Framed for the Court by the Parties
Whether the federal Medicaid Act provides for a state Medicaid program to recover reimbursement for Medicaid’s payment of a beneficiary’s past medical expenses by taking funds from the portion of the beneficiary’s tort recovery that compensates for future medical expenses.
In 2008, Gianinna Gallardo, a 13-year-old student, was hit by a truck after exiting her school bus. Brief for Petitioner, Gianinna Gallardo, at 16. She sustained severe physical injuries and remains in a continual vegetative state. Id. Since Ms.
Additional Resources
- David McGuffey, Medicaid Liens Revisited: Gallardo v. Marstiller, Ez Elder Law (Dec. 7, 2021).
- Geron Gadd, Paying for the Past With the Future: the Scope of Medicaid Recovery for Past Medical Expenses, AARP Foundation (Sept. 20, 2021).
- Jim Sams, Medicaid Recovery Case Before Supreme Court May Drive Up Settlement Costs, Claims Journal (Dec. 6, 2021).