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Florida First DCA reverses Administrative Law Judge’s denial of reduction of Medicaid lien asserted against medical negligence recovery involving a brain damaged infant

On March 12, 2020, in Bryan v. State of Florida, Agency for Health Care Administration (AHCA), No. 1D18-3417, the Florida First DCA reversed an Administrative Law Judge’s denial of a reduction of Medicaid lien asserted against a medical negligence recovery involving a brain damaged infant who was rendered unable to speak, walk, ambulate, eat, toilet, or care for herself in any manner. The plaintiff had argued that the Medicaid lien of $379,559.90 should be reduced by approximately 90% because the $3 million recovery was only 10% of the total damages in the medical negligence case. At the administrative hearing, the plaintiff offered the testimony of two trial attorneys who were both admitted as experts in the valuation of damages and opined as to $30 million valuation based on a life care plan and an economist report. She also submitted an affidavit of a former judge who alleged that based on her training, the plaintiff’s method of calculating the proposed allocation of $38,106.28 was “reasonable, rational, logical, and results in an accurate estimation of the portion of the settlement which should be allocated to past medical expenses.” The AHCA presented no evidence. The First DCA noted that at the time of the final hearing, the ALJ did not have the benefit of the Florida Supreme Court’s decision in Giraldo v. Agency for Health Care Administration, 248 So. 3d 53 (Fla. 2018), or the First DCA’s decisions in Eady v. State, 279 So. 3d 1249, 1259 (Fla. 1st DCA 2019), and Mojica v. State, 285 So. 3d 393, 394 (Fla. 1st DCA 2019), each of which similarly reversed ALJ denials of Medicaid reductions where there was unrebutted evidence presented by the plaintiff regarding the value of damages.

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