Amanda Soto v. Agency for Health Care Administration
CourtDistrict Court of Appeal of Florida
Date FiledNovember 18, 2020
Docket1D17-5387
StatusPublished
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Full Opinion
FIRST DISTRICT COURT OF APPEAL
STATE OF FLORIDA
_____________________________
No. 1D17-5387
_____________________________
AMANDA SOTO,
Appellant,
v.
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Appellee.
_____________________________
On appeal from the Division of Administrative Hearings.
R. Bruce McKibben, Judge.
November 18, 2020
PER CURIAM.
The appellant argues that the administrative law judge (ALJ)
erred when he determined that she was not entitled to a reduction
in the Agency for Health Care Administration’s (AHCA) Medicaid
lien that was imposed against the proceeds from her settlement
with a third-party tortfeasor. The ALJ concluded that the
appellant was not entitled to a reduction because she failed to
prove that her pro rata methodology was sanctioned by the
Legislative mandate for the Medicaid lien to be paid in full.
Since this case was decided by the ALJ, the Florida Supreme
Court and this Court have accepted the use of the pro rata method
to reduce the Medicaid lien when the Medicaid recipient has
presented competent, substantial, and uncontradicted evidence to
support her position that only a portion of the settlement should
be allocated for past medical expenses. ∗ Giraldo v. Agency for
Health Care Admin., 248 So. 3d 53, 56 (Fla. 2018); Bryan v. State,
291 So. 3d 1033, 1036 (Fla. 1st DCA 2020); Mojica v. Agency for
Health Care Admin., 285 So. 3d 393, 398 (Fla. 1st DCA 2019);
Eady, 279 So. 3d at 1259.
The record shows that the appellant presented competent,
substantial, and uncontradicted evidence to support the reduction
of her Medicaid lien by using a pro rata method. AHCA failed to
present any evidence that the appellant’s proposed pro rata
methodology was inaccurate or that another method would be
more appropriate to apply. For those reasons, the ALJ erred as a
matter of law by concluding that the appellant failed to prove that
her Medical lien should have been reduced. See Mojica, 285 So. 3d
at 396−98. Accordingly, we reverse and remand the cause to the
Department of Administrative Hearings for the ALJ to reduce
AHCA’s Medicaid lien to $26,641.59.
REVERSED and REMANDED.
B.L. THOMAS, ROBERTS, and ROWE, JJ., concur.
_____________________________
Not final until disposition of any timely and
authorized motion under Fla. R. App. P. 9.330 or
9.331.
_____________________________
Floyd B. Faglie of Staunton & Faglie, PL, Monticello, for Appellant.
∗
While this case was pending, other similar cases were
pending, and another panel had already set Eady v. State, 279 So.
3d 1249 (Fla. 1st DCA 2019), for oral arguments. Consequently,
multiple supplemental authorities had been filed that this panel
was required to consider.
2
Alexander R. Boler of Boler Legal, PLLC, Tallahassee, for
Appellee.
3