Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1263diff_868c.pdf
Page Number: 25

8 

GALLARDO v. MARSTILLER 

SOTOMAYOR, J., dissenting 

to third-party payments for services the plan has not fur-
nished.  Ibid.; see ante, at 7. 

This  Court’s  task  is  to  interpret  these  provisions  “ ‘as  a 
symmetrical  and  coherent  regulatory  scheme’ ”  while 
“ ‘fit[ting] . . . all parts into an harmonious whole.’ ”  FDA v. 
Brown  &  Williamson  Tobacco  Corp.,  529  U. S.  120,  133 
(2000).  Doing so here leads to only one “symmetrical and 
coherent” conclusion: that the assignment and acquisition
provisions work in tandem to effectuate the third-party lia-
bility provision.  As explained by the United States as ami-
cus curiae in support of Gallardo, Congress “added the belt”
(the acquisition provision) “because it feared that the sus-
penders” (the assignment provision) “were not doing their 
job.”  Brief for United States as Amicus Curiae 29.  The two 
provisions take different paths toward the same goal, and
each  reinforces  the  other.    All  of  the  provisions  enable  a 
State  to  reimburse  itself  for  expenses  it  has  paid,  not  for 
expenses it may or may not incur in the future.  None of the 
provisions  authorize  a  State  to  seek  such  reimbursement
from  the  portions  of  a  beneficiary’s  tort  settlement  repre-
senting payments for care for which the State has not paid.
This interpretation is also consistent with the structure
of the Medicaid program as a whole, under which a State’s 
recovery  from  a  beneficiary’s  compensation  in  tort  is  per-
missible under a narrow exception to the general, asset-pro-
tective  rule  established  by  the  anti-lien  and anti-recovery 
provisions.  Ahlborn further explained that the third-party
liability  provision  and  acquisition  provision  both  “rein-
force[d]  the  limitation  implicit  in  the  assignment  provi-
sion.”  547 U. S., at 280.  In particular, the Court described 
the acquisition provision’s requirement (that a State enact 
laws under which it acquires a beneficiary’s rights to third-
party payments for “health care items or services furnished
to an individual” “under the State plan,” §1396a(a)(25)(H))
as “reiterat[ing]” and “echo[ing]” the assignment provision’s