Synergy Blog

From Roger Baron: 4th Circuit upholds Ahlborn over contrary North Carolina law

Reprinted with Permission from Roger Baron

“The 4th Circuit Court of Appeals handed down E.M.A. v. Cansler, 2012 WL 956187, yesterday. In this case, a child sustained serious injuries at birth due to medical malpractice.  The state of North Carolina paid more than $1.9 million in medical bills. The tort recovery was $2.8 million.  The federal trial court, applying North Carolina law as set forth in state statute and as interpreted by the N.C. Supreme court, awarded Medicaid reimbursement in the amount of one-third of the tort recovery or $933,333.33.  This decision holds that North Carolina law, “as applied in this case, fail[s] to comply with federal Medicaid law as interpreted by the Supreme Court in Ahlborn. As the unanimous Ahlborn Court’s decision makes clear, federal Medicaid law limits a state’s recovery to settlement proceeds that are shown to be properly allocable to past medical expenses.”  The case remanded “for an evidentiary hearing at which the district court shall determine the proper amount of DHHS’s Medicaid lien in accordance with Ahlborn …’ ”

To view the decision click HERE

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