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Taxpayers pay for care; families get damages?

In 2005, a child was born in Ohio with severe brain damage. In 2007, when his mother moved to West Virginia, she enrolled him in this state's Medicaid program.

In 2009, a medical malpractice case was settled for $3.6 million.

As Lawrence Messina of The Associated Press

reported, the Medicaid program then sought to recover at least half of the more than $557,200 it had spent on the child's care.

The mother objected, and a circuit judge limited Medicaid's recovery to $79,000. In June, the state Supreme Court upheld that decision.

But it sparked a clear-thinking dissent from Justice Menis Ketchum:

"As a result of the majority holding, West Virginia's taxpayers will not be reimbursed for the millions of dollars a year it pays on the medical bills of Medicaid recipients," he wrote.

"Settlements paid by insurance companies to Medicaid recipients will be kept by the recipients and West Virginia will keep paying their medical bills."

He added: "West Virginia's taxpayers will be paying, through Medicaid, plaintiff's future medical bills that will total more than $19 million. The plaintiff will be able to use the millions put in the special needs trust as a supplement to enhance quality of life."

Ketchum's dissent prompted Gov. Earl Ray Tomblin to introduce a bill that would require that the state Department of Health and Human Services be notified when Medicaid recipients or their survivors file for damage awards.

The Medicaid program would then become a party to the case. The governor's bill would also specify that the department approve the terms of any settlement.

Well, it's a start, but it doesn't go nearly far enough.

This child's situation is tragic, and his mother's life is changed forever. But the taxpayers are clearly stakeholders in such cases.

They get to pay for the care, and the recipients of free care get to collect what lawyers call "substantial cash awards"?

That idea is a non-starter. Public support for Medicaid is at risk here as well,.

The state should also require full disclosure of attorneys' fees in each case.

If taxpayers are the new deep pocket, they have a right to know how much plaintiffs and their attorneys get out of targeting them.


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