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The Minnesota Supreme Court issued a decision in Getz v. Peace, et. al. that will impact recovery for Medicaid beneficiaries in personal injury cases.

| Oct 21, 2019 | Firm News, Litigation News |

On October 16, 2019, the Minnesota Supreme Court issued a decision in Getz v. Peace, et. al. that will impact recovery for Medicaid beneficiaries in personal injury cases. The Supreme Court held that discounts received by Medicaid are not collateral sources subject to offset. As a result, plaintiffs will be entitled to receive, and defendants will be required to pay, the amount of medical bills awarded by a jury even if the amount actually accepted by the health care provided in full satisfaction of those bills was less than the amount awarded.

In a 5-2 decision, the majority held the plain language of the Minnesota’s collateral source statute, specifically the language excluding “payments made pursuant to the United State Social Security Act,” applied to discounts negotiated by Medicare providers. Justices Gildea dissented, joined by Justice Anderson, and noted there is nothing in the United States Social Security Act that either mandates or dictates the amount of Medicare discounts, and that instead these discounts are the subject of private negotiation.

In light of this decision, cases involving private insurance carriers must be evaluated differently that cases involving Medicaid or Medicare. While defendants are entitled to a collateral source offset for discounts received by private health insurers, no such offset will be available if the plaintiff receives Medicaid or Medicare, increasing a defendant’s exposure at trial.

Brief Summary of Facts

Respondent, Ambree Getz, was in an automobile accident involving a school bus driven by appellant Eila Peace and owned by appellant Palmer Bus Service of Maple River, Inc. Getz sued appellants for negligence, and the case proceeded to trial. The jury found that Getz had incurred damages for past health care expenses in the amount of $224,998. Appellants filed a motion in the trial court for a determination of collateral sources under the collateral source statute, Minn. Stat. § 548.251 (2018). As an enrollee in Medical Assistance / Medicaid, Getz had received benefits for health care expenses through two managed care organizations under Minnesota’s Prepaid Medical Assistance Program. Appellants sought to limit the award of past health care expenses to the amounts the managed care organizations had actually paid, excluding the discounts they had negotiated with Getz’s providers. The trial court ruled that “[t]he only amounts Getz can recover for past health care expenses are the amounts for which her health insurers claim a subrogation interest,” which was $45,979. The Court of Appeals reversed and remanded, holding Medicaid discounts were “payments made pursuant to the United States Social Security Act” and were therefore not a collateral source under the plain language of the statute. In its decision today, the Minnesota Supreme Court affirmed the Court of Appeals.

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