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Division of Medicaid - Mississippi Law
Pursuant to Mississippi law, the Division of Medicaid has “subrogation rights” (not a lien) in the proceeds of a tort judgment or settlement “to the extent of the Division of Medicaid’s interest on behalf of the recipient.” Miss. Code Ann. § 43-13-125(1). This subrogation interest is limited to payments made by the Division of Medicaid “as a result of injuries, disease or sickness caused under circumstances creating a cause of action in favor of the [Medicaid] recipient against a third party.” Id.
Division of Medicaid - Federal Law
Under federal law, the Division of Medicaid may not recover “any portion of a Medicaid beneficiary’s tort judgment or settlement not ‘designated as payments for medical care.’” Wos v. E.M.A. ex rel. Johnson, 2013 WL 1131709 at *1 (U.S. Mar. 20, 2013) (quoting Arkansas Dept. of Health & Human Servs. v. Ahlborn, 547 U.S. 268 (2006)). 42 U.S.C. § 1396a(25)(B) provides that the Division of Medicaid may, in cases where “legal liability is found to exist after medical assistance has been provided” to an individual, “seek reimbursement for such assistance to the extent of such legal liability.”
Division of Medicaid’s subrogation
“The purposes of subrogation are to prevent the insured from recovering twice for the same loss and to reimburse the insurer when a third party should be required to pay for the loss.” Armstrong v. Mississippi Farm Bureau Casualty Ins. Co., 66 So.3d 188, 191 (Miss. Ct. App. 2011).
Division of Medicaid’s burden of proving reasonableness
Under the statute creating the Division of Medicaid’s subrogation interest, Medicaid bears the burden of proving “the amount and correctness of its claim relating to the injury, disease or sickness” that was at issue in the underlying tort action. Miss. Code Ann. § 43-13-125(3).
Division of Medicaid - Court's Reductions
Once Medicaid has borne its burden of proving which of its subrogation claims are “a result of” or “related to” the fault or alleged fault of the third party, this Court is to deduct “[t]he reasonable costs of collection, including attorney’s fees, as approved and allowed by the court”. Miss. Code Ann. § 43-13-125(2). The Court may also account for other factors in setting the amount of Medicaid’s recovery, including a “pro rata” share and the other interests traditionally committed to the Chancery Court in handling minor’s business. Miss. Code Ann. § 43-13-125(2)(b).
Medicaid's Subrogation limited to Cost of Medical care
The Court must deny Medicaid’s subrogation interest entirely if no portion of the settlement at issue is a recovery of costs of medical care. Wos v. E.M.A. ex rel. Johnson, 2013 WL 1131709 at *1 (U.S. Mar. 20, 2013) (quoting Arkansas Dept. of Health & Human Servs. v. Ahlborn, 547 U.S. 268 (2006)).
Manual for Complex Litigation “MCL” – Federal Practice Guide https://public.resource.org/scribd/8763868.pdf
3M Products Liability Litigation, MDL No. 2885 – Master Docket No. 3:19md2885
Young v. BL Development Corp. D/B/A Harrah’s Casino Tunica and Veranda Hotel, Civil Action No. 3:19cv034-NBB-RP, :
It is well-settled that federal courts refer to state law for tolling rules just as they do for statutes of limitation. Wallace v. Keto, 549 U.S. 384 (2007). The broad language of the tolling provision cited by the plaintiff, Miss. Code Ann. § 15-1-57, undoubtedly applies under the circumstances of this case. It cannot be legitimately disputed that the automatic stay and injunction order at issue here prohibited and enjoined the plaintiff from commencing her action against the defendant. Though, as the defendant argues, the plaintiff could have petitioned the bankruptcy court for relief from the stay or order, the applicable tolling provision requires no such action. See Trustmark Nat’l Bank v. Pike County Nat’l Bank, 716 So. 2d 618 (Miss. 1998).
The court finds that the Mississippi tolling provision is applicable under the facts of this case. The result is that the limitations period was tolled during both the automatic stay and the period covered by the injunction order. Accordingly, the plaintiff’s complaint was timely filed, and the defendant’s motion to dismiss is not well taken and shall be denied.