The entire amount of a personal injury settlement is available to satisfy a Medicaid lien.
Christopher Cricchio received Medicaid benefits from December 12, 1986, until July 6, 1993. Allegedly the victim of malpractice by various health care providers, Christopher received a personal injury settlement of $410,000 in 1994. The parties agreed that the proceeds would be placed into a supplemental needs trust. The Department of Social Services obtained a lien on the proceeds to recoup the amount of benefits it had paid to Christopher after he reaches the age of majority.
Reversing lower courts, the Court of Appeals ruled on March 25, 1997, that a Medicaid lien must be paid before a court may authorize the creation of a supplemental needs trust. The court remitted the case to determine how much of the recovery was to compensate the plaintiff for past medical expenses and from that amount to determine the sum owed to satisfy the lien.
On July 1, 1997, the court amended its decision, striking the above and replacing it with the charge that on remittal the lower court must determine whether the entire amount of the personal injury settlement or only the portion attributable to past medical expenses is available to satisfy the lien.
The state Supreme Court rules that the entire amount of the settlement is available to satisfy a Medicaid lien. The court holds that it is bound by the appellate decision in Calvanese v. Calvanese, 672 N.Y.S.2d 410 (App. Div. 2d Dep't 1998), which found that the recoupment provisions of the Social Security law do not limit the right of recovery to the portion of the settlement proceeds inteded to compensate the plaintiff for past medical expenses. Click here for the New York Court of Appeals' affirmation of that ruling.
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