Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1263diff_868c.pdf
Page Number: 2

(Slip Opinion) 

OCTOBER  TERM,  2021 

1 

Syllabus 

NOTE:  Where  it  is  feasible,  a  syllabus  (headnote)  will  be  released,  as  is 
being  done  in  connection  with  this  case,  at  the  time  the  opinion  is  issued. 
The  syllabus  constitutes  no  part  of  the  opinion  of  the  Court  but  has  been 
prepared  by  the  Reporter  of  Decisions  for  the  convenience  of  the  reader. 
See United States v. Detroit Timber & Lumber Co., 200 U. S. 321, 337. 

SUPREME COURT OF THE UNITED STATES 

Syllabus 

GALLARDO, AN INCAPACITATED PERSON, BY AND 
THROUGH HER PARENTS AND CO-GUARDIANS VASSALLO ET 
AL. v. MARSTILLER, SECRETARY OF THE FLORIDA 
AGENCY FOR HEALTH CARE ADMINISTRATION 

CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR 
THE ELEVENTH CIRCUIT 

No. 20–1263.  Argued January 10, 2022—Decided June 6, 2022 

Petitioner Gianinna Gallardo suffered catastrophic injuries resulting in 
permanent disability when a truck struck her as she stepped off her 
Florida  school  bus.    Florida’s  Medicaid  agency  paid  $862,688.77  to 
cover Gallardo’s initial medical expenses, and the agency continues to 
pay  her  medical  expenses.    Gallardo,  through  her  parents,  sued  the 
truck’s owner and driver, as well as the Lee County School Board.  She 
sought  compensation  for  past  medical  expenses,  future  medical  ex-
penses, lost earnings, and other damages.  That litigation resulted in 
a  settlement  for  $800,000,  with  $35,367.52  expressly  designated  as
compensation for past medical expenses.  The settlement did not spe-
cifically allocate any amount for future medical expenses. 

The  Medicaid  Act  requires  participating  States  to  pay  for  certain
needy individuals’ medical costs and then to make reasonable efforts 
to  recoup  those  costs  from  liable  third  parties.
  42  U. S. C. 
§1396k(a)(1)(A).  Under Florida’s Medicaid Third-Party Liability Act, 
a  beneficiary  like  Gallardo  who  “accept[s]  medical  assistance”  from 
Medicaid  “automatically  assigns  to  the  [state]  agency  any  right”  to 
third-party payments for medical care.  Fla. Stat. §409.910(6)(b).  Ap-
plied to Gallardo’s settlement, Florida’s statutory framework entitled
the State to $300,000—i.e., 37.5% of $800,000, the percentage the stat-
ute sets as presumptively representing the portion of the tort recovery
that is for “past and future medical expenses,” absent clear and con-
vincing rebuttal evidence.  §§409.910(11)(f )(1), (17)(b).  Gallardo chal-
lenged  the  presumptive  allocation  in  an  administrative  proceeding.