Alaska Supreme Court won't block Medicaid expansion
Ethics
Thousands of lower-income Alaskans will become eligible for Medicaid after the Alaska Supreme Court on Monday refused to temporarily block the state from expanding the health care program.
The win capped a big day for Alaska Gov. Bill Walker, who earlier flew with President Barack Obama from Washington, D.C., to Anchorage.
"The Alaska Supreme Court's ruling today brings final assurance that thousands of working Alaskans will have access to health care tomorrow," Walker said in a statement issued Monday evening.
Walker earlier this summer announced plans to accept federal funds to expand Medicaid coverage after state legislators tabled his expansion legislation for further review.
The Legislative Council, acting on behalf of lawmakers, sued to stop expansion.
Thirty other states and the District of Columbia have expanded Medicaid, or plan to do so, to include all adults with incomes at or below 138 percent of the federal poverty level.
The federal government agreed to pay all costs for the new enrollees through 2016, but it will begin lowering its share in 2017. States will pay 10 percent of the costs by 2020.
Some Alaska legislators have expressed concern with adding more people to a system they consider broken. Administration officials have acknowledged the current Medicaid program isn't sustainable, but they see expansion as a way to get federal dollars to help finance reform efforts.
On Friday, Superior Court Judge Frank Pfiffner denied the request from lawmakers to halt expansion while a lawsuit moves forward. The Alaska Supreme Court on Monday agreed, saying lawyers for the lawmakers failed to show Pfiffner erred when denying the motion for a preliminary injunction.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.