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State May Not Impose Lien on the Medical Portion of a Settlement
A U.S. District Court holds that Pennsylvania may not place a lien on the medical portion of a settlement because it violates the federal Medicaid law's anti-lien and anti-recovery provisions. Tristani v. Richman (U.S. Dist. Ct., W.D., Pa., No. 06-694, March 25, 2009).
After surgery, Rita L. Tristani suffered a stroke and received Medicaid benefits. She sued her doctors for medical malpractice and received a settlement. Joshua C. Valenta was injured in a car accident and also received Medicaid benefits and a settlement. The state notified the attorneys involved in each case that it maintained a lien on the settlements for medical expenses paid on behalf of Ms. Tristani and Mr. Valenta by the state.
Ms. Tristani and Mr. Valenta sued Estelle B. Richman, Pennsylvania's Secretary of Public Welfare, and Feather Houstoun, Ms. Richman's predecessor, in their individual capacities, making a number of claims including that the liens violated the anti-lien and anti-recovery provisions (42 U.S.C. 1396p(a)(1) and 1396p(b)(1)) of federal Medicaid law. Among other things, Ms. Tristani and Mr. Valenta argued that it was illegal to assert claims against their settlement at all, even for medical expenses. Ms. Richman and Ms. Houstoun asked for summary judgment.
The U.S. District Court for the Western District of Pennsylvania holds that the liens imposed by the state for medical expenses violate the anti-lien and anti-recovery provisions of federal Medicaid law. The court notes that while the Supreme Court in Arkansas Department of Health and Human Services, et al. v. Ahlborn found that the state may not recover non-medical expenses, it left open the question as to whether the state could recover medical expenses. According to the court, the state is free to intervene in the cases or directly represent its own interests, but having failed to do so, it is not entitled to impose liens on settlement proceeds. However, the court grants summary judgment to Ms. Richman and Ms. Houstoun, holding that they have qualified immunity because the law was not clearly established.
A roundup of elder law news and practice development articles culled from news sources across the nation during the week of April 15, 2025, to April 21, 2025.
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State May Not Impose Lien on the Medical Portion of a Settlement
A U.S. District Court holds that Pennsylvania may not place a lien on the medical portion of a settlement because it violates the federal Medicaid law's anti-lien and anti-recovery provisions. Tristani v. Richman (U.S. Dist. Ct., W.D., Pa., No. 06-694, March 25, 2009).
After surgery, Rita L. Tristani suffered a stroke and received Medicaid benefits. She sued her doctors for medical malpractice and received a settlement. Joshua C. Valenta was injured in a car accident and also received Medicaid benefits and a settlement. The state notified the attorneys involved in each case that it maintained a lien on the settlements for medical expenses paid on behalf of Ms. Tristani and Mr. Valenta by the state.
Ms. Tristani and Mr. Valenta sued Estelle B. Richman, Pennsylvania's Secretary of Public Welfare, and Feather Houstoun, Ms. Richman's predecessor, in their individual capacities, making a number of claims including that the liens violated the anti-lien and anti-recovery provisions (42 U.S.C. 1396p(a)(1) and 1396p(b)(1)) of federal Medicaid law. Among other things, Ms. Tristani and Mr. Valenta argued that it was illegal to assert claims against their settlement at all, even for medical expenses. Ms. Richman and Ms. Houstoun asked for summary judgment.
The U.S. District Court for the Western District of Pennsylvania holds that the liens imposed by the state for medical expenses violate the anti-lien and anti-recovery provisions of federal Medicaid law. The court notes that while the Supreme Court in Arkansas Department of Health and Human Services, et al. v. Ahlborn found that the state may not recover non-medical expenses, it left open the question as to whether the state could recover medical expenses. According to the court, the state is free to intervene in the cases or directly represent its own interests, but having failed to do so, it is not entitled to impose liens on settlement proceeds. However, the court grants summary judgment to Ms. Richman and Ms. Houstoun, holding that they have qualified immunity because the law was not clearly established.
State May Not Impose Lien on the Medical Portion of a Settlement
<p>A U.S. District Court holds that Pennsylvania may not place a lien on the medical portion of a settlement because it violates the federal Medicaid law's anti-lien and anti-recovery provisions. <a href="https://attorney.elderlawanswers.com/-i-tristani-v--richman--i---u-s--dist--ct---w-d---pa---no--06-694--march-25--2009--13563"><i>Tristani v. Richman</i></a> (U.S. Dist. Ct., W.D., Pa., No. 06-694, March 25, 2009). </p><p>After surgery, Rita L. Tristani suffered a stroke and received Medicaid benefits. She sued her doctors for medical malpractice and received a settlement. Joshua C. Valenta was injured in a car accident and also received Medicaid benefits and a settlement. The state notified the attorneys involved in each case that it maintained a lien on the settlements for medical expenses paid on behalf of Ms. Tristani and Mr. Valenta by the state. </p><p>Ms. Tristani and Mr. Valenta sued Estelle B. Richman, Pennsylvania's Secretary of Public Welfare, and Feather Houstoun, Ms. Richman's predecessor, in their individual capacities, making a number of claims including that the liens violated the anti-lien and anti-recovery provisions (42 U.S.C. 1396p(a)(1) and 1396p(b)(1)) of federal Medicaid law. Among other things, Ms. Tristani and Mr. Valenta argued that it was illegal to assert claims against their settlement at all, even for medical expenses. Ms. Richman and Ms. Houstoun asked for summary judgment. </p><p>The U.S. District Court for the Western District of Pennsylvania holds that the liens imposed by the state for medical expenses violate the anti-lien and anti-recovery provisions of federal Medicaid law. The court notes that while the Supreme Court in <a href="https://attorney.elderlawanswers.com/-i-arkansas-department-of-health-and-human-services--et-al--v--ahlborn--i---547-u-s--268--2006--13097"><i>Arkansas Department of Health and Human Services, et al. v. Ahlborn</i></a> found that the state may not recover non-medical expenses, it left open the question as to whether the state could recover medical expenses. According to the court, the state is free to intervene in the cases or directly represent its own interests, but having failed to do so, it is not entitled to impose liens on settlement proceeds. However, the court grants summary judgment to Ms. Richman and Ms. Houstoun, holding that they have qualified immunity because the law was not clearly established. </p><p>For the full text of this decision, go to: <A target=_blank href="https://attorney.elderlawanswers.com/-i-tristani-v--richman--i---u-s--dist--ct---w-d---pa---no--06-694--march-25--2009--13563">https://attorney.elderlawanswers.com/-i-tristani-v--richman--i---u-s--dist--ct---w-d---pa---no--06-694--march-25--2009--13563></p>
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