Research case Gallardo v. Marstiller

In your brief, you should include the following information:

1. the Facts (What happened that caused the plaintiff to sue?)
2. the Plaintiff's Theory (Why Plaintiff's thinks is right)
3. the Defendant's Theory (Why Defendant's thinks is right)
4. the Legal Issue (a yes or no question)
5. the Holding of the Court (Yes or no--answers the legal issue).
6. The Reasoning of the Court (i.e.: what facts and laws did the court rely on to decide the case; why the case was decided in the winner's favor; why did the other side lose)
7. The Dissent (a summary dissent)

Gallardo v. Marstiller is a case scheduled for argument before the Supreme Court of the United States on January 10, 2022, during the court's October 2021-2022 term.

HIGHLIGHTS

The issue: The case concerns tort claims and state Medicaid program reimbursement. Click here to learn more about the case's background.

The questions presented: "Whether the federal Medicaid Act provides for a state Medicaid program to recover reimbursement for Medicaids payment of a beneficiarys past medical expenses by taking funds from the portion of the beneficiarys tort recovery that compensates for future medical expenses."[1]

The outcome: The appeal is pending adjudication before the U.S. Supreme Court.

The case came on a writ of certiorari to the United States Court of Appeals for the 11th Circuit.[2] To review the lower court's opinion, click here.

Timeline

The following timeline details key events in this case:

January 10, 2022: The U.S. Supreme Court will hear oral argument.

July 2, 2021: The U.S. Supreme Court agreed to hear the case.

March 9, 2021: Parents and co-guardians Pilar Vassallo and Walter Gallardo appealed to the U.S. Supreme Court on their daughter Gianinna Gallardo's behalf.

October 20, 2020: The United States Court of Appeals for the 11th Circuit denied the petition for rehearing en banc.

Background

Factual and procedural background

In November 2008, 13-year-old student Gianinna Gallardo was struck by a truck after exiting her school bus. As a result of her injuries, Gallardo remains in a permanent vegetative state. Floridas state Medicaid program paid $862,688.77 toward the medical expenses. Gallardo's parents filed a civil suit in state court against the truck owner and driver, and the school board. The suit was settled with court approval for $800,000 awarded to Gallardo's parents, allocated to pay for both past and future medical care. Florida's Medicaid agency was authorized to intervene in the suit and/or file its own suit to seek reimbursement from the third party but did not do so. The agency filed a lien against Gallardo for $862,688.77. According to the state's statutory formula, the agency was entitled to $300,000 of the settlement money. Gallardo contested the lien and deposited the $300,000 into an interest-bearing trust for the state's benefit and filed a petition with the Florida Agency for Health Care Administration. The administrative hearing was temporarily put on hold while the proceedings in federal court progressed.[1][2][3][4]

In 2017, Gallardo sought a federal court determination of her rights under the Medicaid Act. The district court issued a declaratory judgment that the Medicaid Act prohibited the state from seeking reimbursement of past payments from portions of the settlement award allocated for future medical expenses and enjoined, or halted, the state from enforcing the Florida statute allowing such reimbursement.[1]

On June 26, 2020, the U.S. Court of Appeals for the 11th Circuit reversed the district court's judgment. On July 17, 2020, Gallardo filed a petition for a rehearing en banc. The 11th Circuit denied rehearing on October 20, 2020, holding that the Medicaid Act authorized a Florida statute permitting the state to file a lien over settlement money allocated for future medical expenses.[1][2]

The court also noted that its ruling conflicted with the Florida Supreme Court's ruling in Giraldo v. Agency for Health Care Admin. (2018):[2]

For more info Use link 20210309140959810_Final - Gallardo SCOTUS Petition for Cert.pdf (supremecourt.gov) for reference.