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rosie123 Asked August 2013

If dad wins a lawsuit against a hospital will Medicaid take all of it?

My dad was attacked by a psychiatric patient that was in a locked ward and somehow managed to get free and ended up in his room. He punched my dad on his face, head, ears and threw him on the floor and kicked him. 3 of the nursing staff and another patient suffered injuries also but none as severe as dads. Dad has liver and right kidney cancer and the kicks to his abdomen seem to have sped up his cancer symptoms. (jaundice, ammonia levels much higher, abdomen now painful and swollen,no appetite and lots of confusion) He would probably be awarded something but he has been on medicaid for the last 4 yrs which paid for his nh stays and his home health care. I wonder if there is any reason to pursue a lawsuit on his behalf. I will be doing everything pertaining to this as I am his POA. .

igloo572 Aug 2013
JessieBelle has really good points to think about.

Another issue if you sue on their behalf and they get any settlement is the effect of the MEDICARE SECONDARY PAYER ACT. Under this, if Medicare paid at all for any of their care (and they did if they are in a facility for physician and PT charges, etc), then Medicare is required to be repaid to the penny for any Medicare paid for items that were covered for the lawsuit and paid by the settlement. Attorney's fees are not included in the Secondary Payer Act too.

JessieBelle Aug 2013
Lawsuits are meant to pay for the damage caused. In this case it would be the need for medical care. So, yes, any money he was awarded for care would be applied to his bill. If the state already paid it, they would probably want to be reimbursed. Money that he received for punitive damages, pain, and suffering would be subject to spend-down. IOW, he would use this money to live until it ran out. This is the only logical way I can see it happening if your father won a lawsuit.

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Perseverance Aug 2013
No one is equipped to answer your question on this forum, unless they are an elder attorney. Go find one. What an awful situation. May God bless you and your father.

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