By Debra P. Klauber, Esq.
FIRST DISTRICT ADHERES TO THE “PRO RATA” METHOD TO SUPPORT REDUCTION OF MEDICAID LIENS.
Domingo v. Agency for Health Care Admin., 1D18-2573, 45 Fla. L. Weekly D2603 (Fla. 1st DCA Nov. 18, 2020); Soto v. Agency for Health Care Admin., 1D17-5387, 45 Fla. L. Weekly D2604 (Fla. 1st DCA Nov. 18, 2020).
An injured plaintiff can initiate an administrative proceeding in order to challenge or reduce a Medicaid lien. In a pair of recent cases, the First District held that the ALJ erred in refusing to reduce the Medicaid liens where the plaintiffs had presented evidence, using the pro rata method, that only a portion of the settlement proceeds should be used to satisfy their liens. Where the Agency for Health Care Administration failed to present any evidence that the pro rata methodology was inaccurate, or that another method would be appropriate, the ALJ should have reduced the liens accordingly.
UNIVERSITY OF MIAMI PROTECTED BY SOVEREIGN IMMUNITY FOR SERVICES PROVIDED BY ITS EMPLOYEE AT JACKSON MEMORIAL HOSPITAL.
In 2011, after the Florida Legislature amended the sovereign immunity statute to include teaching hospitals, the University of Miami and Jackson Memorial Hospital entered into an agreement under which the University of Miami’s employees and faculty, while treating patients at Jackson, are considered agents of the public hospital. The trial court agreed, and the Third District affirmed, the University’s contention that it was entitled to sovereign immunity under the new version of the statute and the affiliation agreement.
FIFTH DISTRICT CLARIFIES CAUSATION STANDARD IN WHISTLEBLOWER CASES.
The trial court instructed the jury that it could find in favor of the plaintiff, who claimed retaliation, if it found that the employer’s intent to punish him for engaging in a protected activity was a motivating factor, even if it was not the only reason for terminating him. The Fifth District reversed based on the United States Supreme Court’s recent determination that the more stringent “but for” test has to be applied in this context. The jury should have been instructed that it could find for the plaintiff only if it found that his termination would not have occurred but for his employer retaliating against his protected activity.
THIRD DISTRICT CONFIRMS APPLICABLE STANDARD FOR AN AWARD OF FEES UNDER 57.105.
In order to award attorneys’ fees as a sanction under section 57.105 of the Florida Statutes, the trial court “must” find that the action was frivolous or so devoid of merit, both on the facts and the law, as to be completely untenable. Absent such findings, this case was revered and remanded for further proceedings.
ATTORNEYS’ FEES UPHELD AS SANCTION FOR PLAINTIFFS’ FRIVOLOUS FILINGS AND GENERAL DISREGARD OF COURT ORDERS.
After a hearing, the trial court concluded that the defendants were entitled to recover attorneys’ fees under Florida Statute 57.105. The court found that the plaintiffs knew or should have known that their claims were not supported by the facts, or the law, and that their counsel was precluded from asserting reliance on the representations of the clients. The court gave the plaintiffs and their counsel an opportunity to object to the detailed time and cost entries, but their filings did not comply with the court order, provide legal authority for their objections, or challenge the hourly rates. The appellate court agreed that their failure to appropriately respond to the order on fees resulted in a waiver of their arguments, and upheld the order awarding those fees and costs.