Should we be horrified because the city has filed a lien against the estates of two patients who died at D.C. Village? The question arises in connection with the cases of George Spells, who died after being burned in a scalding tub, and Wilhelmina Franklin, who froze to death after wheeling herself out of the nursing home one night last winter. In both cases, relatives charge that the city was negligent in supervising the care of these elderly people, and suits for millions of dollars in damages have been filed. The city, in turn, has filed a lien against the estates of the deceased to recover the cost of the care that was provided over a number of years.
A lawyer for one of the relatives is infuriated by the city's move. "They are saying they can kill people as long as they asthey are on public assistance. Why don't they just give the nurses syringes to go off and kill people?" he asks. Negligence lawyers are entitled to a little hyperbole, of course, but is the city as heartless and scheming as he charges? We don't think so.
The first thing you should keep in mind is that the city is required by federal law to recover Medicaid expenses if, in fact, a recipient or his estate has assets. Congress specifically enacted this requirement so that states would collect not only in cases of fraud but also when assets have been acquired legitimately, as a result of an insurance claim or a lawsuit, for example. The requirement to file liens is imposed on every state -- and the District of Columbia -- as a condition of participating in the Medicaid program, and any money recovered must be shared 50-50 with the federal government. City officials routinely check probate court every week to find out whether estates have been opened for former Medicaid patients and automatically file liens as they did in these cases.
It is not unprecedented for the city to recover Medicaid payments even in cases when the funds at stake are the result of a negligence case against the city. A Medicaid patient recently sued the city for injuries caused by a police car, and the city, in turn, claimed reimbursement for the free medical care provided. Recovery against an estate needn't be attempted if a person who has died leaves a spouse or minor children. But that is not the case in either of the D.C. Village disputes.
The federal law, and the action taken by city officials pursuant to that law, are reasonable measures designed to recover funds on behalf of the taxpayers. Lawyers who think these rules are unfair will have to take their case to Congress.