Hedgebeth v. Medford

In Hedgebeth v. Medford, 74 N.J. 360, 378 A.2d 226 (1977), a case decided before the enactment of N.J.S.A. 30:4D-7.1, the Court held that when the State exercises its right of subrogation under the Medicaid program, equitable principles govern, and in seeking reimbursement, the State must pay its pro rata share of the recipient's counsel fees. The New Jersey Supreme Court considered the priority of a per quod claim when New Jersey sought to enforce a Medicaid lien against a plaintiff's recovery. The Court gave priority to the Medicaid claim and observed that a per quod claim can never rise higher than the direct claim arising from the accident. The Court reasoned that since both awards, that of the injured person and his spouse, would logically be used to pay the injured party's bills, "there is a substantial unity between the two awards." Id. at 374, 378 A.2d 226. The Court further indicated that it interpreted the Medicaid act as providing the State with "two avenues by which it may seek reimbursement for Medicaid payments: it may either institute an action directly against the tortfeasor who is liable for the medical expenses or seek recovery by way of the Medicaid recipient through a right of subrogation." Id. at 365, 378 A.2d 226. The Court added that the legislative history of New Jersey's Medicaid program suggested "an unmistakable intent to afford the State every opportunity to recoup its payments from third parties." Id. at 366, 378 A.2d 226. The Court also refused to distinguish an award to a parent from an award to a child by stating: We are satisfied that both awards--to the mother and the infant--should be treated alike for the purposes of the State's claim. Even if a technical distinction exists between the awards made to the mother and child, such an argument runs counter to the overriding purpose of the statute. Id. at 374, 378 A.2d 226 Thus, under Hedgebeth, all of the settlement proceeds are available for reimbursement of the State's Medicaid payments