Louisiana Personal Injury: Can I Recover Money Damages for Bills Paid by Medicaid?

October 18, 2022 General

Louisiana Personal Injury: Can I Recover Money Damages for Bills Paid by Medicaid?

Yes, under Louisiana law, a victim of an accident may recover money damages as compensation for medical bills resulting from an injury even if the bills were paid by Medicaid. In Louisiana, this is known as the “collateral source rule” which is legally complicated. But, in simple terms, a personal injury victim is entitled to compensation even if the bills were paid by some other person or entity — that is, paid by a collateral source.

However, with respect to Medicaid payments, a victim of an accident can only recover, as compensation, the medical expenses actually paid by Medicaid to a medical provider plus any amounts paid or owed by the victim. That is, a victim cannot base his or her claim for compensation on the amount billed or invoiced by the medical provider. This is provided by Louisiana statute. See La. Rev. Stat., 9:2800.27(C).

Let’s look at a couple of examples. First, assume that a person was injured in a Louisiana auto accident. The injury resulted in necessary medical services at a local hospital, various post-discharge physical therapy treatments and the procurement of prescription medications.

Assume that the hospital and physical therapy billed to Medicaid at $11,000, but Medicaid only paid $10,000. Further assume that Medicaid only paid 80% of the $10,000 and the victim was still responsible for the remaining $2,000. Under this example, the person could seek compensation for the full $10,000 that was paid by Medicaid and owed by the person injured in the accident. In this hypothetical, we assume that the hospital and the physical therapist are not seeking to be paid the additional $1,000. Maybe they are prevented from seeking the extra $1,000 or maybe they have chosen to waive payment.

With respect to the prescription medication, let’s assume the cost is $500 with a co-pay owed by the victim injured in the accident. Again, the full $500 could be recovered since $450 was actually paid by Medicaid and the victim paid (or owes) the remaining $50. On the other hand, if Medicaid only paid $300 and the pharmacy does not otherwise seek to recover the extra $150, then the amount that can be recovered is $350.

Next, let’s change the hypothetical example and assume that the hospital and the physical therapist is still seeking payment of the extra $1,000 that was not paid by Medicaid. In that circumstance, the victim injured in the Louisiana auto accident can seek recovery of the extra $1,000 because the person is still legally liable to pay the amount.

Note that the same rule applies to payments made by an insurance company. An insurance carrier is another type of “collateral source.” Again, what can be recovered is generally limited to what is actually paid or owed.

Our Attorneys Can Help 

For more information, contact the Louisiana personal injury lawyers at Mansfield, Melancon, Cranmer & Dick LLC. We have a proven track record of success handling many types of Louisiana personal injury cases including car accidents, boating accidents, motorcycle accidents, premises liability accidents, and cases involving nursing care facility abuse/neglect. Contact us by calling one of our offices: New Orleans at (504) 500-1108, Baton Rouge at (225) 612-0800, or Lafayette at (337) 409-0003. You can also request a free consultation by using our “Contact Us” page.