Document: 547 U.S. 268 (2006) ARKANSAS DEPARTMENT OF HEALTH AND HUMAN SERVICES et al. v. AHLBORN No. 04-1506. Supreme Court of United States. Argued February 27, 2006. Decided May 1, *271 Lori Freno, Assistant Attorney General Arkansas, argued the cause for petitioners. With her on briefs was Mike Beebe, General. Patricia A. Millett States as amicus curiae urging reversal. brief were Solicitor Clement, Keisler, Deputy Kneedler, William Kanter, and Anne Murphy. H. David Blair respondent. him Phillip Farris.[*] *272 JUSTICE STEVENS delivered opinion Court. When a Medicaid recipient in Arkansas obtains tort settlement following payment medical costs behalf by Medicaid, law automatically imposes lien an amount equal to Medicaid's costs. that exceeds portion represents costs, satisfaction State's requires out proceeds meant compensate damages distinct from costslike pain suffering, lost wages, loss future earnings. The Appeals Eighth Circuit held this statutory contravened federal therefore unenforceable. Ahlborn Dept. Human Servs., 397 F.3d 620 (2005). Other courts have upheld similar provisions. See, e. g., Houghton Department Health, 2002 UT 101, 57 P.3d 1067; Wilson Washington, 142 Wash. 2d 40, 10 1061 (2000) (en banc). We granted certiorari resolve conflict, 545 1165 (2005), now affirm. I On January 2, 1996, respondent Heidi Ahlborn, then 19-year-old college student aspiring teacher, suffered severe *273 permanent injuries result car accident. She left brain damaged, unable complete education, incapable pursuing chosen career. Although she possessed claim uncertain value against alleged tortfeasors who caused injuries, Ahlborn's liquid assets insufficient pay care. Petitioner Health Services (ADHS) [1] accordingly determined eligible assistance paid providers $215,645.30 under plan. ADHS required questionnaire about accident, sent attorney periodic letters advising outlays. These noted that, law, had reimbursement "any settlement, judgment, or award" obtained "a third party may be liable for" no "shall satisfied without first giving [ADHS] notice reasonable opportunity establish its interest."[2] has never asserted, however, duty reimburse it any other subsequently acquired April 11, 1997, filed suit two state court seeking compensation sustained 1996 claimed not only past but also physical injury; expenses; pain, mental anguish; earnings working time; impairment ability earn future. neither named nor formally notified suit. counsel did, keep informed details concerning insurance coverage they became known during litigation. *274 In 1998, intervened lawsuit assert third-party recovery might obtain. October asked notify agency if there hearing case. No apparently occurred, case settled sometime total $550,000. parties did allocate between categories damages. participate ask negotiations. Nor seek reopen judgment after been dismissed. $215,645.30the cost payments made September 30, 2002, action District Eastern declaration violated laws insofar would require depletion than expenses. To facilitate Court's resolution legal questions presented, stipulated entire reasonably valued at $3,040,708.12; amounted approximately one-sixth sum; construction correct, entitled ($35,581.47) constituted made. See App. 17-20. Ruling cross-motions summary which concluded conflict with assigned right full extent benefit. Accordingly, $215,645.30. *275 reversed. It represented For reasons follow, we II crux parties' dispute lies their competing constructions laws. program, provides joint funding care individuals cannot afford own launched 1965 enactment Title XIX Social Security Act (SSA), added, 79 Stat. 343, 42 C. § 1396 seq. (2000 ed. Supp. III). Its administration is entrusted Secretary (HHS), turn exercises his authority through Centers Medicare (CMS).[3] are all them do. program cooperative one; Federal Government pays 50% 83% State incurs patient care,[4] and, return, complies certain requirements making eligibility determinations, collecting maintaining information, administering program. 1396a. One such requirement charge (here, ADHS) "take measures ascertain liability . services available plan." 1396a(a)(25)(A) *276 ed.).[5] agency's obligation extends beyond mere identification, however; "in where found exist individual can expect recover recovery, local will liability." 1396a(a)(25)(B). parties, must, "to plan make assistance, [have] effect which, health items furnished individual, considered rights services." 1396a(a)(25)(H). enact assignment reiterated another provision SSA, reads follows: "(a) purpose assisting collection support owed recipients approved subchapter, shall "(1) provide condition *277 capacity execute himself, required "(A) assign (specified administrative order) party; "(B) cooperate obtaining (described subparagraph (A)) himself .; "(C) identifying, providing information assist pursuing, ." 1396k(a). Finally, collected made" described above retained necessary of" recipient. 1396k(b). "[T]he remainder shall paid" Ibid. Acting pursuant understanding these provisions, passed purport allow both recipient, either independently together, "the benefits" parties. Ark. Code Ann. §§ 20-77-301 XX-XX-XXX (2001). Initially, "[a]s eligibility" applicant award benefit applicant." 20-77-307(a). "[w]hen benefits provided" "because injury, disease, disability person liable," so provided." 20-77-301(a).[6]*278 ADHS' "shall" not, "be bar upon recipient." 20-77-301(b). Indeed, statute envisions sometimes sue together ADHS, see 20-77-303, even alone. If latter, 20-77-307(a) received party." 20-77-307(c); 20-77-302(a) ("When brought ., subject division's provided program").[7] State, statute, claims entitlement more just entirety recipient's behalf. if, example, sues alone settles tortfeasor $20,000, behalf, gets whole nothing. This when one hand, like other. same rule *279 apply, seems, jury verdict. case, could $20,000 face allocation of, say, $10,000 expenses.[8] That what confirmed Servs. Ferrel, 336 297, 984 S.W.2d 807 (1999), refused endorse equitable, nontextual interpretation statute. Rejecting argument he ought retain some cover expenses, explained: "Given clear, unambiguous language apparent legislature intended ADHS's recoup restricted equitable subrogation principles `made whole' stated [Franklin Healthsource 328 163, 942 837 (1997)]. By creating automatic expressly becomes lien, [Ark. 20-77-307 (1991)] makes unequivocal statement settlements, chooses, superior does costs." Id., 308, S.W.2d, 811. enforceable authorizes imposition before Court, Circuit, *280 goes too far. agree. Arkansas' finds fact squarely conflicts anti-lien III must decide whether lay expenses.[9] text provisions suggests not; focuses eligibility, "assign party," 1396k(a)(1)(A) (emphasis added), for, wages. relies contrary; indeed, reinforces limitation implicit provision. First, points 1396a(a)(25)(B)'s "seek [medical] liability" added) means fair game. fact, evident context emphasized language, "such refers added). Here, accepted overall damages, $35,581.47 sum Under circumstances, *281 relevant "liability" further amount.[10] Second, argues 1396a(a) (25)(H) favors view demand settlement. provision, echoes mandatory 1396k(a), says individual," give mean, limited behalf tortfeasor's particular But reading ignores rest clear [the recipient] 1396a(a)(25)(H) Again, sanction anything expensesnot inheritance. requiring actively pursues party, reimbursed fully assignment" collected" remitted view, shows Brief Petitioners 13. But, assuming applies cases litigation, conclusion rests false premise: *282 "amount recovered assumes, settlement; explained above, extend 1396k(b) representing care.[11] At very least, then, care.[12] They mandate scheme described. *283 IV plausibly argue supplied "floor" free build. though, places express limits powers pursue funds limitations contained 1396a(a)(18) 1396p. Section comply 1396p, prohibits (except circumstances here) placing liens against, from, recipient: Imposition property account rendered imposed prior death plan, except incorrectly [in here] "(b) Adjustment correctly adjustment *284 made, except here]." Read literally isolation, prohibition 1396p(a) appear ban care.[13] us go far, though; assumes consistent encumbers designated Her argument, rather, precludes attachment encumbrance There question right, chose action, receive So much 1396a(a)(25) And assume, do "assign" advance constitute forced authorized terms exception Washington Guardianship Estate Keffeler, 537 371, 383-385, n. 7 (2003). mean force place on, property. As carved *285 1396k(a) Beyond applies. tries avoid characterizing "property."[14] appears effected State.[15] 31 ("[U]nder attach `property' because attaches those already eligibility"). fails reasons. insists times until actiona included attached materialized. "assignment 20-77-307(c) (2001) "received" reduced possession. assertion belonged along lacks merit. instant applied inconsistent creation *286 proceeds. Why, all, need property? A typically debt Black's Law Dictionary 922 (6th 1990). Nothing defines term otherwise. called "assignment" alter analysis. employs describe mechanism lays themselves, tell violates Craft, 535 274, 279 (2002); Drye States, 528 49, 58-61 (1999). denominated "assignment," here divest interest; instead, payments, asserted fruits once effect, least recognizes, property.[16] Since none excepts operation law. *287 V amici urge, violate cases, permitting apply breached "cooperate" inherent danger manipulation settle judicial oversight input State. Neither persuasive. proposes default whenever breaches "cooperate," asserts duty.[17] Government's allegations obstruction supported record, conception strays far regulations. arises principally, exclusively, proceedings initiated 1396k(a)(1)(C) (recipients "cooperate identifying pursuing" parties). Most accompanying regulations simply echo basic duty; add "[p]ay covered rights." CFR 433.147(b)(4) event, aspersions casts entirely unsupported; record reveals despite having *288 apprised hearings, involved Whatever bounds cooperate, evidence here. States' alternative needed generally risk colorable, ultimately unpersuasive. issue course, presented here; properly Even absence postsettlement agreement, away interest avoided agreement or, necessary, submitting matter decision.[18] risks underestimating readily calculable negotiations, countervailing concern absolute priority preclude large number unfair others.[19] *289 VI contends Appeals' decision below accords weight decisions Departmental Board HHS (Board) rejecting appeals California denial claims. Pet. Cert. 45-67 (reproducing re & Dec. 1561, WL 157123 (HHS Bd., Feb. 7, 1996)); 68-86 1504, 1995 66334 Jan. 5, 1995)). Because opinions address different posed here, mention questionable conclude control our Normally, recovers owes reimbursement, returned. 433.140(a)(2) (2005) (federal financial participation "is [t]he party"); 433.140(c). adopted schemes according refrained claiming settlements instead took each (In California, 72; proportion varied id., 48-51.) Each resulted costsa sought partial Government. CMS (then HCFA) denied *290 ground expenses tortfeasors. CMS' determinations. California's appeal, came first, "from sources fullest possible" demanding 76. acknowledged "refers `payment care,'" thought contemplates actual greater is, should first." gave siding CMS: legislative history evinced congressional intent possible," ibid.; second, long shortfall resulting failure 77. opined escape relying efforts litigating 79-80. responding incentives thirdparty thus lower observed state's share" compromise share. 85. reached conclusion, means, 53-64. adjudications compels comports Board's rulings *291 concerned had, failed relied act private attorneys general. discussed cited acknowledgment clarity language. Moreover, resort whole" justification muddying nowhere explained. Given 1396a(a)(25), 1396k(b), 75-76; 54-55, given concession limit care, "statutory scheme" authorize portions allocated allocable nonmedical damages; gives disbursement supra, 282. adjudication conceded much: "[CMS] over [thirdparty liability] suits though distribution methodology set forth section [1396k(b)] assignments care." 54 reasoning internally inconsistent. Third, reliance misplaced. Congress, crafting legislation, "payer last resort." S. Rep. 99-146, p. 313 (1985). Congress themselves; possible *292 beneficiaries. 1396p(a). recognize delegated "broad regulatory [of HHS] area," Wisconsin Family Blumer, 534 473, 496, 13 (2002), warrant deference. couples internal inconsistency conscious disregard text. decline treat controlling. VII exceeding $35,581.47, affirmatively doing so. unenforceable compel conclusion. affirmed. ordered. NOTES [*] reversal Rob McKenna, L. Williams, Senior General, Kimberly D. Frinell, Attorneys respective jurisdictions W. Márquez Alaska, Terry Goddard Arizona, John Suthers Colorado, Richard Blumenthal Connecticut, Robert J. Spagnoletti Columbia, Thurbert E. Baker Georgia, Mark Bennett Hawaii, Lawrence G. Wasden Idaho, Lisa Madigan Illinois, Phill Kline Kansas, Gregory Stumbo Kentucky, Steven Rowe Maine, Joseph Curran, Jr., Maryland, Thomas F. Reilly Massachusetts, Michael Cox Michigan, Jeremiah (Jay) Nixon Missouri, McGrath Montana, Kelly Ayotte New Hampshire, Peter Harvey Jersey, Eliot Spitzer York, Wayne Stenehjem North Dakota, Jim Petro Ohio, Hardy Myers Oregon, Patrick Lynch Rhode Island, Henry McMaster South Carolina, Long Shurtleff Utah, Peggy Lautenschlager Wisconsin, Crank Wyoming. Louis M. Bograd, Ned Miltenberg, Kenneth Suggs Association Trial Lawyers America affirmance. Services. [2] Affidavit Olive, Exhs. 5 6 (Mar. 6, 2003). [3] Until 2001, Care Financing Administration HCFA. 66 Fed. Reg. 35437. [4] exact percentage contribution calculated formula keyed per capita income. 1396d(b). [5] "third party" defined regulation entity part expenditures 433.136 [6] broader sues, "no contributory comparative fault attributed state, restitution awarded 20-77-301(d)(1) [7] independent, nonderivative National Bank Commerce Quirk, 323 769, 792-794, 918 138, 151-152 (1996). [8] denies actually 13, prevent [9] we, fulfill obligations procures own. Cf. 1396k(a)(1)(B)(C) (the identify "provid[e] added)). [10] stipulation trial judge $3,040,708.12 (of expenses), negligence, [11] Implicit assumption "remainder" remit seems always exceed earmarked holds up. acknowledge, often pocket. Amicus Curiae 12 (under beneficiary retains additional personally incurred subsequent damages"); CMS, Manual 3907, https://www.lexis. com>Legal>Secondary Legal>CCH>Health Law>CMS Program Manuals>CCH Manuals P 3907 (as updated Mar. 25, 2006, Clerk file) (envisioning "medical payments," possible). outlays drafted exclusively mind. insurance, policy enough [12] concedes larger itself allocated. 13; 22, 14 (noting "ordinarily accepts" debt, smaller expenses). textual basis treating differently judge-allocated award; awards party's "payment care" heads [13] Likewise, subsection (b) forestall attempt paid, "individual." Martin ex rel. Hoff Rochester, 642 N.W.2d 8, (Minn. 2002); Wallace Jackson, 972 P.2d 446, 450 (Utah 1998) (Durham, J., dissenting) (reading 1396p "prohibi[t] paid"). cite discuss antirecovery 1396p(b). leave day impact [14] "Property" homestead personal real interest." 433.36(b) [15] "property" passes hands en route comes attached." 18. (and infra page), characterization point: [16] "Arkansas sue," 33 original), reach impermissible "circumvent restrictions liquidates certain." 6. acknowledges cannot, inheritance civil related arguably different; choses wages [17] (alleging "omitt[ed] understat[ed] attempt[ed] horde herself payments"); 15 ("[H]aving forsaken duties candid forthcoming cooperation[,] respondent, rather taxpayers, bear consequences actions"); 21, 24 (referring "backdoor settlement" "obstruction attrition," well "calculated evasion obligations"). [18] observes, special rules procedures allocating where, insurers' issue. 20-21. matter, open possibility employed meet concerns manipulation. [19] point illustrated involving workers' employee (or family employee) whose tortfeasor. Flanigan Labor Industry, 123 418, 869 (1994), satisfy injured worker's spouse consortium. department "share compensation" "absurd fundamentally unjust." 426, P.2d, 17.

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