Smith v. Mahoney

This issue this case presented for the Supreme Court's review centered on whether the collateral source rule should apply when Medicaid pays for an injured party’s medical expenses. The Delaware Supreme Court held that, when Medicaid has paid an injured party’s medical expenses, the collateral source rule cannot be used to increase an injured party’s recovery of past medical expenses beyond those actually paid by Medicaid. "As with Medicare, the difference is unnecessary to make the injured party whole because it is paid by no one." Appellant Jennifer Smith, was injured in two car collisions. Although employed when her injuries occurred, Smith qualified for Medicaid coverage. At first, her treating physician sought to recover his standard charges of $22,911 from the proceeds of any personal injury settlement. But later, the treating physician opted to forego his original billed amount, and instead billed Medicaid for his charges. Medicaid paid the treating physician $5,197.71, and asserted a lien in that amount on the proceeds of any recovery by settlement or lawsuit. When all was netted out, the Superior Court entered judgment against the defendants jointly and severally for $49,911. Relying on the applicable case law, the trial court determined that “Delaware case law is clear that the collateral source rule does not apply to Medicaid or Medicare write-offs.” In its decision here, the Delaware Supreme Court refused to extend operation of the collateral source rule and affirmed the superior court's judgment. Also affirmed was the Superior Court’s ruling that future medical expenses were not subject to Medicaid reimbursement limitations. "Unlike Medicare, Medicaid coverage is income dependent, and might not be available if a plaintiff improves her financial position to a living wage and secures other insurance. Because of the uncertainty of future coverage, Medicaid benefits cannot be used to limit a plaintiff’s future medical expenses." View "Smith v. Mahoney" on Justia Law