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Page Number: 3.0

2 

GALLARDO v. MARSTILLER 

Syllabus 

She also brought this lawsuit seeking a declaration that Florida was
violating  the  Medicaid  Act  by  trying  to  recover  from  portions  of  the  
settlement compensating for future medical expenses.  The Eleventh 
Circuit concluded that the relevant Medicaid Act provisions do not pre-
vent a State from seeking reimbursement from settlement monies al-
located for future medical care.  963 F. 3d 1167, 1178. 

Held: The Medicaid Act permits a State to seek reimbursement from set-

tlement payments allocated for future medical care.  Pp. 5–12. 

(a) Gallardo  argues  that  the  Medicaid  Act’s  anti-lien  provision—
which prohibits States from recovering medical payments from a ben-
eficiary’s  “property,”  §1396p(a)(1)—forecloses  recovery  from  settle-
ment amounts other than those allocated for past medical care paid for
by Medicaid.  But this Court has held that the provision does not apply
to state laws “expressly authorized by the terms of §§1396a(a)(25) and
1396k(a)” of the Medicaid Act.  Arkansas Dept. of Health and Human 
Servs. v. Ahlborn, 547 U. S. 268, 284.  Here, Florida’s Medicaid Third-
Party  Liability  Act—under  which  Florida  may  seek  reimbursement 
from  settlement  amounts  representing  “payment  for  medical  care,” 
past  or  future—“is  expressly  authorized  by  the  terms  of  . . . 
[§]1396k(a)” and thus falls squarely within the “exception to the anti-
lien provision” that this Court has recognized.  Ibid. 

The  plain  text  of  §1396k(a)(1)(A)  decides  this  case.  Nothing  in 
§1396k(a)(1)(A) limits a beneficiary’s assignment to payments for past
“medical care” already paid for by Medicaid.  To the contrary, the grant 
of “any rights . . . to payment for medical care” most naturally covers 
not only rights to payment for past medical expenses, but also rights 
to payment for future medical expenses.  §1396k(a)(1)(A); see United 
States v. Gonzales, 520 U. S. 1, 5.  The relevant distinction is thus “be-
tween medical and nonmedical expenses,” Wos v. E. M. A., 568 U. S. 
627, 641, not between past and future medical expenses. 

Statutory context reinforces that §1396k(a)(1)(A)’s reference to “pay-
ment for medical care” is not limited as Gallardo suggests.  For exam-
ple, when the Medicaid Act separately requires state plans to comply
with §1396k, it describes that provision as imposing a “mandatory as-
signment of rights of payment for medical support and other medical 
care  owed  to  recipients.”    §1396a(a)(45)  (emphasis  added).    Section 
1396a(a)(45) thus distinguishes only between medical and nonmedical
care, not between past (paid) medical care payments and future (un-
paid) medical care payments.  If Congress had intended to draw such 
a  distinction,  “it  easily  could  have  drafted  language  to  that  effect.” 
Mississippi ex rel. Hood v. AU Optronics Corp., 571 U. S. 161, 169.  In 
fact,  Congress  did  include  more  limiting  language  elsewhere  in  the 
Medicaid Act.  Section 1396a(a)(25)(H), which requires States to enact