{ "id": 4149277, "name": "KATELYN ANDREWS, a minor, through her Guardian ad Litem, DAVID ANDREWS; and DAVID ANDREWS and ANDREA ANDREWS, individually v. VANESSA P. HAYGOOD, M.D., individually; CENTRAL CAROLINA OBSTETRICS AND GYNECOLOGY, P.A., a North Carolina Corporation; THE WOMEN'S HOSPITAL OF GREENSBORO, a North Carolina Not-for-Profit Corporation; KIM RICHEY, R.N., individually; and JENNIFER DALEY, R.N., individually v. NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF MEDICAL ASSISTANCE, Intervenor", "name_abbreviation": "Andrews v. Haygood", "decision_date": "2008-12-12", "docket_number": "No. 57A07-2", "first_page": "599", "last_page": "613", "citations": [ { "type": "official", "cite": "362 N.C. 599" } ], "court": { "name_abbreviation": "N.C.", "id": 9292, "name": "Supreme Court of North Carolina" }, "jurisdiction": { "id": 5, "name_long": "North Carolina", "name": "N.C." }, "cites_to": [ { "cite": "655 S.E.2d 440", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12640216 ], "year": 2008, "opinion_index": -1, "case_paths": [ "/se2d/655/0440-01" ] }, { "cite": "188 N.C. App. 244", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 4155551 ], "year": 2008, "opinion_index": -1, "case_paths": [ "/nc-app/188/0244-01" ] }, { "cite": "547 U.S. 268", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 3276324 ], "year": 2006, "opinion_index": -1, "case_paths": [ "/us/547/0268-01" ] }, { "cite": "641 S.E.2d 4", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12637898, 12637899 ], "year": 2006, "opinion_index": 0, "case_paths": [ "/se2d/641/0004-01", "/se2d/641/0004-02" ] }, { "cite": "623 S.E.2d 79", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12634747 ], "year": 2005, "opinion_index": 0, "case_paths": [ "/se2d/623/0079-01" ] }, { "cite": "631 S.E.2d 131", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12636051 ], "year": 2006, "opinion_index": 0, "case_paths": [ "/se2d/631/0131-01" ] }, { "cite": "655 S.E.2d 440", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12640216 ], "weight": 3, "year": 2008, "pin_cites": [ { "page": "444" }, { "page": "444-45", "parenthetical": "Wynn, J., dissenting" } ], "opinion_index": 0, "case_paths": [ "/se2d/655/0440-01" ] }, { "cite": "402 S.E.2d 627", "category": "reporters:state_regional", "reporter": "S.E.2d", "weight": 2, "year": 1991, "pin_cites": [ { "page": "636-37", "parenthetical": "Martin, J., dissenting" } ], "opinion_index": 0 }, { "cite": "328 N.C. 436", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 2538798 ], "year": 1991, "pin_cites": [ { "page": "451-52", "parenthetical": "Martin, J., dissenting" } ], "opinion_index": 0, "case_paths": [ "/nc/328/0436-01" ] }, { "cite": "237 S.E.2d 819", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1977, "pin_cites": [ { "page": "821-22" } ], "opinion_index": 0 }, { "cite": "293 N.C. 348", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8564139 ], "year": 1977, "pin_cites": [ { "page": "350-52" } ], "opinion_index": 0, "case_paths": [ "/nc/293/0348-01" ] }, { "cite": "135 S.E.2d 659", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1964, "pin_cites": [ { "page": "661" } ], "opinion_index": 0 }, { "cite": "261 N.C. 645", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8575129 ], "year": 1964, "pin_cites": [ { "page": "647" } ], "opinion_index": 0, "case_paths": [ "/nc/261/0645-01" ] }, { "cite": "399 S.E.2d 311", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1991, "pin_cites": [ { "page": "314-15" } ], "opinion_index": 0 }, { "cite": "328 N.C. 24", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 2545728 ], "year": 1991, "pin_cites": [ { "page": "29" } ], "opinion_index": 0, "case_paths": [ "/nc/328/0024-01" ] }, { "cite": "665 S.E.2d 449", "category": "reporters:state_regional", "reporter": "S.E.2d", "weight": 2, "year": 2008, "pin_cites": [ { "page": "453" }, { "page": "453" } ], "opinion_index": 0 }, { "cite": "362 N.C. 457", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 4149743 ], "weight": 2, "year": 2008, "pin_cites": [ { "page": "463" }, { "page": "463" } ], "opinion_index": 0, "case_paths": [ "/nc/362/0457-01" ] }, { "cite": "361 N.C. 180", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 3740806, 3739192, 3743444, 3745080, 3744891 ], "year": 2006, "opinion_index": 0, "case_paths": [ "/nc/361/0180-01", "/nc/361/0180-04", "/nc/361/0180-03", "/nc/361/0180-02", "/nc/361/0180-05" ] }, { "cite": "175 N.C. App. 56", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8349938 ], "year": 2005, "opinion_index": 0, "case_paths": [ "/nc-app/175/0056-01" ] }, { "cite": "360 N.C. 529", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 3788743 ], "year": 2006, "opinion_index": 0, "case_paths": [ "/nc/360/0529-01" ] }, { "cite": "188 N.C. App. 244", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 4155551 ], "year": 2008, "pin_cites": [ { "page": "247" } ], "opinion_index": 0, "case_paths": [ "/nc-app/188/0244-01" ] }, { "cite": "547 U.S. 268", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 3276324 ], "weight": 52, "year": 2006, "pin_cites": [ { "page": "275" }, { "page": "1758" }, { "page": "468" }, { "page": "275-77" }, { "page": "1758-59" }, { "page": "468-70" }, { "page": "279-80" }, { "page": "1760-61" }, { "page": "470-71" }, { "page": "278-79" }, { "page": "1759-60" }, { "page": "470-71" }, { "page": "274" }, { "page": "1757-58" }, { "page": "468" }, { "page": "273" }, { "page": "1757" }, { "page": "467" }, { "page": "274" }, { "page": "1757" }, { "page": "468" }, { "page": "274" }, { "page": "1757-58" }, { "page": "468" }, { "page": "292" }, { "page": "1767" }, { "page": "479" }, { "page": "288" }, { "page": "1765" }, { "page": "476" }, { "page": "282" }, { "page": "1762" }, { "page": "472-73" } ], "opinion_index": 0, "case_paths": [ "/us/547/0268-01" ] }, { "cite": "641 S.E.2d 4", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12637898, 12637899 ], "weight": 2, "year": 2006, "pin_cites": [ { "parenthetical": "requiring the recipient's attorney to \"distribute to the Department the amount of assistance paid by the Department on behalf of or to the beneficiary, as prorated with the claims of all others having medical subrogation rights or medical liens against the amount received or recovered\"" } ], "opinion_index": 1, "case_paths": [ "/se2d/641/0004-01", "/se2d/641/0004-02" ] }, { "cite": "623 S.E.2d 79", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12634747 ], "weight": 2, "year": 2005, "pin_cites": [ { "page": "85" } ], "opinion_index": 1, "case_paths": [ "/se2d/623/0079-01" ] }, { "cite": "631 S.E.2d 131", "category": "reporters:state_regional", "reporter": "S.E.2d", "case_ids": [ 12636051 ], "weight": 2, "year": 2006, "opinion_index": 1, "case_paths": [ "/se2d/631/0131-01" ] }, { "cite": "431 U.S. 1", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 1636 ], "weight": 7, "year": 1977, "pin_cites": [ { "page": "25-26" }, { "page": "111-12" }, { "page": "31" }, { "page": "115" }, { "page": "151" }, { "page": "25-26" }, { "page": "112", "parenthetical": "alteration in original" } ], "opinion_index": 1, "case_paths": [ "/us/431/0001-01" ] }, { "cite": "500 S.E.2d 54", "category": "reporters:state_regional", "reporter": "S.E.2d", "weight": 3, "year": 1998, "pin_cites": [ { "page": "66", "parenthetical": "citing U.S. Trust Co. of N.Y. v. New Jersey, 431 U.S. 1, 25-26, 52 L. Ed. 2d 92, 111-12 (1977)" }, { "page": "67" }, { "page": "66" } ], "opinion_index": 1 }, { "cite": "348 N.C. 130", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 1659878 ], "year": 1998, "pin_cites": [ { "page": "151", "parenthetical": "citing U.S. Trust Co. of N.Y. v. New Jersey, 431 U.S. 1, 25-26, 52 L. Ed. 2d 92, 111-12 (1977)" } ], "opinion_index": 1, "case_paths": [ "/nc/348/0130-01" ] }, { "cite": "417 U.S. 927", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 1519592, 1519842, 1519512, 1519808 ], "year": 1974, "opinion_index": 1, "case_paths": [ "/us/417/0927-03", "/us/417/0927-04", "/us/417/0927-02", "/us/417/0927-01" ] }, { "cite": "201 S.E.2d 905", "category": "reporters:state_regional", "reporter": "S.E.2d", "pin_cites": [ { "page": "908" } ], "opinion_index": 1 }, { "cite": "284 N.C. 534", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8563071 ], "pin_cites": [ { "page": "538" } ], "opinion_index": 1, "case_paths": [ "/nc/284/0534-01" ] }, { "cite": "154 S.E.2d 344", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1967, "pin_cites": [ { "page": "356" } ], "opinion_index": 1 }, { "cite": "270 N.C. 160", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 8566370 ], "year": 1967, "pin_cites": [ { "page": "173-74" } ], "opinion_index": 1, "case_paths": [ "/nc/270/0160-01" ] }, { "cite": "361 N.C. 180", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 3740806, 3739192, 3743444, 3745080, 3744891 ], "year": 2006, "opinion_index": 1, "case_paths": [ "/nc/361/0180-01", "/nc/361/0180-04", "/nc/361/0180-03", "/nc/361/0180-02", "/nc/361/0180-05" ] }, { "cite": "175 N.C. App. 56", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8349938 ], "weight": 2, "year": 2005, "pin_cites": [ { "page": "65-66" } ], "opinion_index": 1, "case_paths": [ "/nc-app/175/0056-01" ] }, { "cite": "360 N.C. 529", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 3788743 ], "weight": 2, "year": 2006, "opinion_index": 1, "case_paths": [ "/nc/360/0529-01" ] }, { "cite": "547 U.S. 268", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 3276324 ], "weight": 33, "year": 2006, "pin_cites": [ { "page": "284-85" }, { "page": "474" }, { "page": "275" }, { "page": "468-69" }, { "page": "275" }, { "page": "469" }, { "page": "276" }, { "page": "469" }, { "page": "276-77" }, { "page": "272" }, { "page": "467", "parenthetical": "internal citations omitted" }, { "page": "284-85" }, { "page": "474" }, { "page": "280" }, { "page": "471", "parenthetical": "alteration in original" }, { "page": "282" }, { "page": "472" }, { "page": "288" }, { "page": "476" }, { "page": "284" }, { "page": "474" }, { "page": "292" }, { "page": "479" }, { "page": "288" }, { "page": "476" }, { "page": "288" }, { "page": "476" } ], "opinion_index": 1, "case_paths": [ "/us/547/0268-01" ] } ], "analysis": { "cardinality": 1263, "char_count": 38232, "ocr_confidence": 0.747, "pagerank": { "raw": 1.8578070692186215e-07, "percentile": 0.7244339341791741 }, "sha256": "49892801f158982e90ea4cfd488ac18bb9f0ae4d0198e44f0427ad5b846e2302", "simhash": "1:d0cb1e18349204d6", "word_count": 6097 }, "last_updated": "2023-07-14T21:47:03.529976+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "Justices BRADY and TIMMONS-GOODSON join in this dissenting opinion." ], "parties": [ "KATELYN ANDREWS, a minor, through her Guardian ad Litem, DAVID ANDREWS; and DAVID ANDREWS and ANDREA ANDREWS, individually v. VANESSA P. HAYGOOD, M.D., individually; CENTRAL CAROLINA OBSTETRICS AND GYNECOLOGY, P.A., a North Carolina Corporation; THE WOMEN\u2019S HOSPITAL OF GREENSBORO, a North Carolina Not-for-Profit Corporation; KIM RICHEY, R.N., individually; and JENNIFER DALEY, R.N., individually v. NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF MEDICAL ASSISTANCE, Intervenor" ], "opinions": [ { "text": "NEWBY, Justice.\nThis case presents the question of whether the statutory framework governing the State\u2019s subrogation claim for medical expenses on a Medicaid recipient\u2019s tort claim settlement complies with federal Medicaid law as interpreted by the Supreme Court of the United States in Arkansas Department of Health & Human Services v. Ahlborn, 547 U.S. 268, 126 S. Ct. 1752, 164 L. Ed. 2d 459 (2006). Because Ahlborn does not mandate a specific method for determining the medical expense portion of a plaintiff\u2019s settlement, we uphold North Carolina\u2019s reasonable statutory scheme and accordingly affirm the Court of Appeals.\nPlaintiff Katelyn Andrews brought suit against defendants, alleging medical malpractice and seeking recovery for injuries she sustained at birth. The parties entered into confidential settlement agreements and established a settlement account for the proceeds. Because Katelyn is a North Carolina Medicaid recipient, the North Carolina Division of Medical Assistance (\u201cDMA\u201d) sought to recover from the account the amount it paid for her medical expenses, $1,046,681.94. The trial court determined the DMA has subrogation rights to the entire amount of the settlement, limited by the statutory provision that only one-third of a recovery is subject to subrogation. N.C.G.S. \u00a7 108A-57(a) (2005). Because the amount expended by the DMA was less than one-third of the settlement, the trial court ordered full reimbursement. The trustee of the settlement account appealed.\nThe Court of Appeals affirmed the trial court\u2019s order based on our prior decision in Ezell v. Grace Hospital, Inc., 360 N.C. 529, 631 S.E.2d 131 (2006), rev\u2019g per curiam for reasons stated in the dissenting opinion, 175 N.C. App. 56, 623 S.E.2d 79 (2005), reh\u2019g denied, 361 N.C. 180, 641 S.E.2d 4 (2006). Andrews v. Haygood, 188 N.C. App. 244, 247, 655 S.E.2d 440, 444 (2008). However, a dissent questioned the majority\u2019s reliance on Ezell because in reversing the Court of Appeals, we did not specifically address the applicability of the holding in Ahlborn to the issues in Ezell. Id. at-, 655 S.E.2d at 444-45 (Wynn, J., dissenting).\nBased on the dissent, the trustee appealed to this Court, and we granted review of additional issues arising from the trial court\u2019s denial of requests for an evidentiary allocation hearing and for a delay in resolution of the case until a third party could be joined. The trustee contends that absent an agreement between the parties, federal law requires a judicial determination of the portion of a tort claim settlement that represents the recovery of medical expenses. In response, the DMA contends the statutory one-third limiting provision complies with Ahlbom\u2019s interpretation of federal Medicaid law. The DMA thus argues that judicial apportionment of medical expenses from the settlement is not required. We agree.\nMedicaid is a cooperative program that provides federal and state medical care funding for certain individuals who are unable to afford their own medical costs. See Ahlborn, 547 U.S. at 275, 126 S. Ct. at 1758, 164 L. Ed. 2d at 468. Participating states are required by federal law to \u201ctake all reasonable measures to ascertain the legal liability of third parties ... to pay for care and services available under the plan\u201d and to \u201cseek reimbursement for [medical] assistance [made av\u00e1ilable on behalf of a recipient] to the extent of such legal liability.\u201d 42 U.S.C. \u00a7 1396a(a)(25)(A)-(B) (2000). State laws control the administration of the program, including the method by which a state may seek reimbursement for prior Medicaid assistance. See Ahlborn, 547 U.S. at 275-77, 126 S. Ct. at 1758-59, 164 L. Ed. 2d at 468-70. State laws, however, must comply with federal Medicaid law. Id.\nThe Supreme Court of the United States addressed the operation of a state\u2019s Medicaid reimbursement statute in Ahlbom, in which the Court was asked to determine whether the Arkansas Department of Health and Human Services (\u201cADHS\u201d) could claim a statutory lien on a settlement for more than the portion that by stipulation represented the recovery of medical expenses. Ahlborn, 547 U.S. at 279-80, 126 S. Ct. at 1760-61, 164 L. Ed. 2d at 470-71. The Arkansas statutes in question allowed total reimbursement to ADHS for all previous medical payments made on the plaintiff\u2019s behalf. Id. at 278-79, 126 S. Ct. at 1759-60, 164 L. Ed. 2d at 470-71. Ahlborn, a Medicaid recipient, challenged the statute because it permitted reimbursement from settlement proceeds recovered for damages other than medical expenses. Id. at 274, 126 S. Ct. at 1757-58, 164 L. Ed. 2d at 468. In her suit against the alleged tortfeasors, she sought compensation for medical expenses, pain and suffering, lost wages, and permanent impairment of her future wage-earning ability. Id. at 273, 126 S. Ct. at 1757, 164 L. Ed. 2d at 467. After the parties settled for $550,000, ADHS asserted a lien against the settlement for $215,645.30 \u2014 the total amount of prior payments made by ADHS for Ahlborn\u2019s medical care. Id. at 274, 126 S. Ct. at 1757, 164 L. Ed. 2d at 468. Ahlborn challenged the lien, alleging it violated federal Medicaid law \u201cinsofar as its satisfaction would require depletion of compensation for injuries other than past medical expenses.\u201d Id.\nBefore trial, Ahlborn and ADHS stipulated to several facts. Id. at 274, 126 S. Ct. at 1757-58, 164 L. Ed. 2d at 468. The reasonable value of Ahlborn\u2019s claim, absent any consideration of liability, was specified to be approximately $3,040,708.18. Id. The parties agreed the settlement amount of $550,000 represented approximately one-sixth of the estimated total damages. Id. ADHS further stipulated that if Ahlborn\u2019s construction of the Arkansas statute were correct, ADHS would only be entitled to reimbursement for one-sixth of the total past medical payments, or $35,581.47. Id.\nThe Supreme Court of the United States determined that ADHS was entitled to recover $35,581.47, the portion of the settlement stipulated to represent Ahlborn\u2019s recovery of medical expenses. Id. at 292, 126 S. Ct. at 1767, 164 L. Ed. 2d at 479. The Court held: \u201cFederal Medicaid law does not authorize ADHS to assert a lien on Ahlborn\u2019s settlement in an amount exceeding $35,581.47 .... Arkansas\u2019 third-party liability provisions are unenforceable insofar as they compel a different conclusion.\u201d Id. Ahlborn thus controls when there has been a prior determination or stipulation as to the medical expense portion of a plaintiff\u2019s settlement. In those cases, the State may not receive reimbursement in excess of the portion so designated.\nThe Ahlbom holding, limited by the parties\u2019 stipulations, did not require a specific method for determining the portion of a settlement that represents the recovery of medical expenses. See id. at 288, 126 S. Ct. at 1765, 164 L. Ed. 2d at 476. The Court recognized that \u201csome States have adopted special rules and procedures for allocating tort settlements\u201d under certain circumstances, but ultimately \u201cexpress[ed] no view on the matter\u201d and \u201cle[ft] open the possibility that such rules and procedures might be employed to meet concerns about settlement manipulation.\u201d Id. at 288 n.18, 126 S. Ct. at 1765 n.18, 164 L. Ed. 2d at 476 n.18. Ahlborn thus does not mandate a judicial determination of the portion of a settlement from which the State may be reimbursed for prior medical expenditures. Instead, the Supreme Court left to the States the decision on the measures to employ in the operation of their Medicaid programs. Id.\nOur General Assembly created a statutory method to determine the amount of the State\u2019s reimbursements for prior medical payments. North Carolina law provides that Medicaid recipients are \u201cdeemed to have made an assignment to the State of the right to third party benefits, contractual or otherwise to which [the recipient] may be entitled.\u201d N.C.G.S. \u00a7 108A-59(a) (2005). Implementation of the recipient\u2019s statutory assignment is governed by section 108A-57(a) of our General Statutes:\nNotwithstanding any other provisions of the law, to the extent of payments under this Part, the State . . . shall be subrogated to all rights of recovery, contractual or otherwise, of the beneficiary of this assistance . . . against any person. . . . Any attorney retained by the beneficiary of the assistance shall, out of the proceeds obtained on behalf of the beneficiary by settlement with ... a third party... distribute to the Department the amount of assistance paid by the Department... but the amount paid to the Department shall not exceed one-third of the gross amount obtained or recovered.\nId. \u00a7 108A-57(a) (2005) (emphasis added). While encouraging complete recovery for past medical payments, the North Carolina statute allows total reimbursement to the State only when \u201cthe amount of assistance\u201d previously paid for medical expenses is one-third of the plaintiff\u2019s settlement or less. Id. If the amount of the State\u2019s claim exceeds one-third of the recovery, our statute limits reimbursement to one-third of the settlement. Id. Section 108A-57(a) thus prevents excessive depletion of a plaintiff\u2019s recovery to satisfy the State\u2019s reimbursement lien. Nonetheless, plaintiffs are free to negotiate a settlement with the State for a lien amount less than that required by our statutes.\nRather than requiring a specific determination of the medical expense portion of a settlement, North Carolina employs an alternative statutory procedure that we believe is permitted by Ahlborn. See Ahlborn, 547 U.S. at 288 n.18, 126 S. Ct. at 1765 n.18, 164 L. Ed. 2d at 476 n.18. Our state law defines \u201cthe portion of the settlement that represents payment for medical expenses\u201d as the lesser of the State\u2019s past medical expenditures or one-third of the plaintiff\u2019s total recovery, limiting the State\u2019s reimbursement to the portion so designated. See N.C.G.S. \u00a7 108A-57(a); see also Ahlborn, 547 U.S. at 282, 126 S. Ct. at 1762, 164 L. Ed. 2d at 472-73. The one-third limitation of section 108A-57(a) thus comports with Ahlbom by providing a reasonable method for determining the State\u2019s medical reimbursements, which it is required to seek in accordance with federal Medicaid law. See 42 U.S.C. \u00a7 1396a(25)(A)-(B) (2000).\nThis statutory scheme protects plaintiffs\u2019 interests while promoting efficiency in Medicaid reimbursement cases throughout North Carolina. In enacting our statute, the General Assembly may have considered factors such as the strain on resources to send State employees across North Carolina to participate in evidentiary allocation hearings each time a Medicaid recipient recovers from a third party. Likewise, the legislature may have found it important that a case-by-case determination of the medical expense portion of settlements could lead to variable results and increased litigation due to inconsistency in outcomes. Certainly, \u201c[w]eighing these and other public policy considerations is the province of our General Assembly, not this Court.\u201d Shaw v. U.S. Airways, Inc., 362 N.C. 457, 463, 665 S.E.2d 449, 453 (2008).\nWe accord a presumption of validity to the General Statutes of this State. See, e.g., Wayne Cty. Citizens Ass\u2019n for Better Tax Control v. Wayne Cty. Bd. of Comm\u2019rs, 328 N.C. 24, 29, 399 S.E.2d 311, 314-15 (1991); Ramsey v. N.C. Veterans Comm\u2019n, 261 N.C. 645, 647, 135 S.E.2d 659, 661 (1964). When the General Assembly enacts a statute after examining its legal and public policy implications, it is not the province of this Court to substitute its judgment for that of our legislature. See, e.g., Shaw, 362 N.C. at 463, 665 S.E.2d at 453; Newlin v. Gill, 293 N.C. 348, 350-52, 237 S.E.2d 819, 821-22 (1977); see also Bockweg v. Anderson, 328 N.C. 436, 451-52, 402 S.E.2d 627, 636-37 (1991) (Martin, J., dissenting). As we previously did in Ezell, we have again reviewed section 108A-57(a) and find it to be a reasonable framework that comports with the requirements of federal Medicaid law as interpreted by Ahlborn. If the General Assembly desires a different result in these cases it may amend the statutes accordingly.\nWe therefore affirm the Court of Appeals\u2019 holding that the trial court did not err in subrogating the plaintiff\u2019s settlement proceeds to the DMA, subject to the one-third statutory limitation. Because our resolution of this issue is dispositive, we need not address the requested joinder of United Healthcare and the Court of Appeals decision as to that issue remains undisturbed.\nAFFIRMED; DISCRETIONARY REVIEW IMPROVIDENTLY ALLOWED IN PART.\n. The pertinent sections of the Arkansas Code read:\nAs a condition of eligibility, every Medicaid applicant shall automatically assign his or her right to any settlement, judgment, or award which may be obtained against any third party to the Department of Human Services to the full extent of any amount which may be paid by Medicaid for the benefit of the applicant.\nArk. Code. Ann. \u00a7 20-77-307(a) (2001) (emphasis added). Accordingly, \u201cwhen medical assistance benefits are provided . . . to a . . . recipient because of injury, disease, or disability for which another person is liable . . . the Department of Human Services shall have a right to recover from the person the cost of benefits so provided.\" Id. \u00a7 20-77-301(a) (2001) (emphasis added).", "type": "majority", "author": "NEWBY, Justice." }, { "text": "Justice HUDSON\ndissenting.\nAlthough I agree with the majority that \u201c[Arkansas Department of Health & Human Services v. ] Ahlborn does not mandate a specific method for determining the medical expense portion of a plaintiff\u2019s settlement,\u201d the United States Supreme Court nevertheless did explicitly hold in Ahlborn that a State may not violate the anti-lien provisions of 42 U.S.C. \u00a7\u00a7 1396a(a)(18) and 1396p by requiring a Medicaid recipient to reimburse it out of settlement funds designated for purposes other than medical care. 547 U.S. 268, 284-85, 164 L. Ed. 2d 459, 474 (2006). The terms of the settlement at issue here provide insufficient detail to allow us to determine whether the application of N.C.G.S. \u00a7 108A-57(a) would violate the anti-lien provisions of the federal Medicaid statutes, pursuant to the holding in Ahlborn. Because I conclude that we are bound to follow Ahlbom, I must respectfully dissent.\nAs observed by the United States Supreme Court, the federally funded and administered Medicaid program is \u201ca cooperative one,\u201d with participating states \u201ccomplfying] with certain statutory requirements for making eligibility determinations, collecting and maintaining information, and administering the program\u201d in exchange for the federal funding. Id. at 275, 164 L. Ed. 2d at 468-69. Among these requirements is \u201cthat the state agency in charge of Medicaid . . . \u2018take all reasonable measures to ascertain the legal liability of third parties ... to pay for care and services available under the plan.\u2019 \u201d Id. at 275, 164 L. Ed. 2d at 469 (quoting 42 U.S.C. \u00a7 1396a(a)(25)(A) (2000) (alteration in original)). Further,\nThe [state] agency\u2019s obligation extends beyond mere identification, however; \u201cin any case where such a legal liability is found to exist after medical assistance has been made available on behalf of the individual and where the amount of reimbursement the State can reasonably expect to recover exceeds the costs of such recovery, the State or local agency will seek reimbursement for such assistance to the extent of such legal liability.\u201d\nId. at 276, 164 L. Ed. 2d at 469 (quoting 42 U.S.C. \u00a7 1396a(a)(25)(B)). The federal Medicaid statutes obligate participating states to enact so-called \u201cassignment laws\u201d to provide for such reimbursement. Id. at 276-77, 164 L. Ed. 2d at 469-70 (citing 42 U.S.C. \u00a7\u00a7 1396a(a)(25)(H), 1396k(a)).\nIn enacting section 108A-57(a), our General Assembly fulfilled this requirement while also explicitly limiting the percentage of a settlement that the State could recover through assignment:\nNotwithstanding any other provisions of the law, to the extent of payments under this Part, the State, or the county providing medical assistance benefits, shall be subrogated to all rights of recovery, contractual or otherwise, of the beneficiary of this assistance, or of the beneficiary\u2019s personal representative, heirs, or the administrator or executor of the estate, against any person. The county attorney, or an attorney retained by the county or the State or both, or an attorney retained by the beneficiary of the assistance if this attorney has actual notice of payments made under this Part shall enforce this section. Any attorney retained by the beneficiary of the assistance shall, out of the proceeds obtained on behalf of the beneficiary by settlement with, judgment against, or otherwise from a third party by reason of injury or death, distribute to the Department the amount of assistance paid by the Department on behalf of or to the beneficiary, as prorated with the claims of all others having medical subrogation rights or medical liens against the amount received or recovered, but the amount paid to the Department shall not exceed one-third of the gross amount obtained or recovered.\nN.C.G.S. \u00a7 108A-57(a) (2005) (emphases added). Moreover, the General Assembly specifically provided that \u201cthe provisions of this Part shall be liberally construed in relation to [the federal Social Security Act providing grants to the states for medical assistance] so that the intent to comply with it shall be made effectual.\u201d Id. \u00a7 108A-56 (2005). In my view, the majority\u2019s interpretation runs contrary to this directive by risking violations of the federal anti-lien provisions, which would render our State out of compliance with Medicaid requirements and thereby jeopardize the funding our State receives.\nThe General Assembly\u2019s explicit direction that we defer to the federal provisions as necessary guides our consideration of the interaction of these federal and state statutes. In addition, because this case involves questions of federal statutory law, we are bound by the United States Supreme Court\u2019s interpretation of the federal Medicaid statutes. As this Court has stated:\nIt is elementary that an act of Congress, in pursuance of the Constitution of the United States, is the supreme law of the land. Constitution of the United States, Article VI, Clause 2. Thus, in case of a conflict between such an act and the law of North Carolina, the act of Congress controls and, so long as it remains in effect, modifies the law of this State and the authority of its courts to render judgment in accordance therewith. It is equally well settled that a decision of the Supreme Court of the United States, construing an act of Congress, is conclusive and binding upon this Court.\nR.H. Bouligny, Inc. v. United Steelworkers, 270 N.C. 160, 173-74, 154 S.E.2d 344, 356 (1967). The United States Supreme Court decision in Ahlborn directly addresses and determines the question presented by this case, as our state statute is similar to the one at issue in Ahlborn and the factual situations are analogous. Therefore, I conclude that Ahlborn is binding upon this Court, and its reasoning and holding compel the conclusion that the application of N.C.G.S. \u00a7 108A-57(a) here, without any further determination of how the settlement proceeds were allocated among the different types of damages alleg\u00e9d by plaintiff, would be contrary to federal law.\nIn delivering the opinion of a unanimous Court in Ahlborn, Justice John Paul Stevens framed the issue as follows:\nWhen a Medicaid recipient in Arkansas obtains a tort settlement following payment of medical costs on her behalf by Medicaid, Arkansas law automatically imposes a lien on the settlement in an amount equal to Medicaid\u2019s costs. When that amount exceeds the portion of the settlement that represents medical costs, satisfaction of the State\u2019s lien requires payment out of proceeds meant to compensate the recipient for damages distinct from medical costs \u2014 like pain and suffering, lost wages, and loss of future earnings. The Court of Appeals for the Eight Circuit held that this statutory lien contravened federal law and was therefore unenforceable. Other courts have upheld similar lien provisions. We granted certiorari to resolve the conflict and now affirm.\n547 U.S. at 272, 164 L. Ed. 2d at 467 (internal citations omitted). Thus, contrary to the majority\u2019s assertion that the Ahlborn holding controls only in situations in which there has been \u201ca prior determination or stipulation as to the medical expense portion of a plaintiff\u2019s settlement,\u201d the Supreme Court in no way rested its analysis on whether a settlement had been so allocated.\nRather, the Supreme Court in Ahlborn \u201cexpressed] no view on\u201d how such allocation should be determined \u201c[e]ven in the absence of such a postsettlement agreement,\u201d id. at 547 at 288 & n.18, 164 L. Ed. 2d at 476 & n.18, emphasizing instead simply that, regardless of how an allocation is made, \u201cthe exception carved out by [the anti-lien provisions laid out in 42 U.S.C. \u00a7\u00a7 1396a(a)(18) and 1396p] is limited to payments [by the third party to the plaintiff-beneficiary] for medical care. Beyond that, the anti-lien provision applies,\u201d id. at 284-85, 164 L. Ed. 2d at 474. Indeed, the Court repeatedly emphasized this point as to \u201cwhether [a state agency] can lay claim to more than the portion of [the plaintiff-beneficiary\u2019s] settlement that represents medical expenses\u201d:\nThe text of the federal third-party liability provisions suggests not; it focuses on recovery of payments for medical care. Medicaid recipients must, as a condition of eligibility, \u201cassign the State any rights ... to payment for medical care from any third party,\u201d 42 U.S.C. \u00a7 1396k(a)(l)(A) (emphasis added), not rights to payment for, for example, lost wages.\nId. at 280, 164 L. Ed. 2d at 471 (alteration in original). More explicitly, \u201cunder the federal statute the State\u2019s assigned rights extend only to recovery of payments for medical care.\u201d Id. at 282, 164 L. Ed. 2d at 472. Likewise, \u201cassignment of the right to compensation for lost wages and other nonmedical damages is nowhere authorized by the federal third-party liability provisions.\u201d Id. at 286 n.16, 164 L. Ed. 2d at 475 n.16.\nThese statements broadly prohibit a state\u2019s claim to reimbursement from any funds not earmarked solely for medical expenses under any circumstances. Accordingly, to the extent that the terms of a settlement are unclear as to the portion designated for medical expenses, the Ahlborn analysis requires states to fashion a method to make those determinations and protect their right to reimbursement, for example, \u201cby obtaining the State\u2019s advance agreement to an allocation or, if necessary, by submitting the matter to a court for decision.\u201d Id. at 288, 164 L. Ed. 2d at 476. Simply put, an indispensable step in calculating the amount of a State\u2019s right to reimbursement for medical expenses is establishing how much of a third-party settlement has been allocated to the medical expenses of the plaintiff-beneficiary.\nThe majority would hold that in N.C.G.S. \u00a7 108A-57(a), the General Assembly attempted to do just that and that the statute \u201ccomports with Ahlborn by providing a reasonable method for determining the State\u2019s medical reimbursements,\u201d namely, capping the reimbursement at no more than one-third of a beneficiary\u2019s settlement with a third party. However, application of the bright-line rule articulated by the majority in a case like this one, in which there has been no allocation, could allow precisely the result that is explicitly barred by Ahlborn. In fact, this would be the outcome with any settlement in which the amount actually paid by the Division of Medical Assistance (DMA) is greater than the amount of the settlement designated for medical expenses, but less than the one-third cap specified in N.C.G.S. \u00a7 108A-57(a).\nA hypothetical example illustrates this point. Suppose a plaintiff \u2014 a past beneficiary of Medicaid assistance \u2014 settles with a tort feasor for $2 million following an automobile accident. She initially alleged damages totaling $5 million, including $500,000 in past medical expenses, $1 million in future medical expenses, $1.5 million in pain and suffering, and $2 million in lost future earnings income. Medicaid, through DMA, paid the full $500,000 in actual past medical costs for the beneficiary\u2019s treatment following the accident. Under the majority\u2019s holding and application of N.C.G.S. \u00a7 108A-57(a), DMA would be entitled to $500,000 of the settlement. However, without knowing more about how the parties allocated the settlement among the different types of damages sought, the amounts might suggest that the parties, as in Ahlborn, reached a settlement that prorated the beneficiary\u2019s damages, awarding her forty percent of what she sought in each category of damages. In that scenario, of the $2 million settlement, $200,000 would be designated for past medical expenses, $400,000 for future medical expenses, $600,000 for pain and suffering, and $800,000 for lost future earnings income. Awarding the full $500,000 to DMA would thus exceed the $200,000 designated for past medical expenses and clearly violate the explicit holding of Ahlborn.\nLikewise, N.C.G.S. \u00a7 108A-57(a) and the majority opinion make no distinction between past medical expenses paid by DMA that relate directly to the injury that is the basis of the settlement and expenses that were paid for treatment of a preexisting, ongoing condition. For example, in the scenario outlined above, suppose DMA had paid $500,000 in medical costs for the beneficiary, but only $300,000 of that amount related to the automobile accident, with the balance of $200,000 spent on treatment for the beneficiary\u2019s leukemia. Under the majority\u2019s holding, DMA could still claim the full $500,000 from the beneficiary, as that amount does not exceed the one-third statutory limitation in N.C.G.S. \u00a7 108A-57(a) \u2014 even though that recovery would include reimbursement for medical expenses totally unrelated to the accident or the settlement. This result, permitted by this Court\u2019s earlier holding in Ezell v. Grace Hospital, Inc., 360 N.C. 529, 631 S.E.2d 131, rev\u2019g per curiam for reasons stated in the dissent 175 N.C. App. 56, 623 S.E.2d 79 (2005), reh\u2019g denied, 361 N.C. 180, 641 S.E.2d 4 (2006), would clearly violate the anti-lien provisions of the federal Medicaid statutes, contrary to the holding of Ahlbom. As such, I also believe we should overrule that decision.\nHere, as in Ahlborn, plaintiff\u2019s civil suit sought damages including, but not limited to, past medical expenses paid by Medicaid and others; the complaint also alleged damages for mental and physical pain and anguish, severe and permanent injury, future medical expenses, loss of future earnings, disfigurement and loss of normal use of her body, her parents\u2019 expenses for education and life care, and her parents\u2019 emotional distress and derivative claims. These claims were settled among all parties, with proceeds held in a single account and no allocations made as to which specific amounts represented damages for which particular type of claim. Nevertheless, the parties clearly intended the settlement to account for all of the different types of damages alleged not just by plaintiff, but also by her parents. The parties concede that the amount of the settlement here allows DMA to be fully reimbursed for the entire $1,046,681.94 it had paid through October 2005 for plaintiff\u2019s medical care, without violating the one-third cap of N.C.G.S. \u00a7 108A-57(a). However, the lack of stipulation or other determination as to the allocation of the settlement funds among the damages leaves us unable to conclude whether a DMA lien for full reimbursement would impermissibly entitle DMA to an amount greater than the medical expenses portion of the settlement, as is prohibited by Ahlborn.\nIn addition, the majority misinterprets N.C.G.S. \u00a7 108A-57(a) as being the General Assembly\u2019s blanket determination that the full one-third of any settlement amount between a plaintiff and a third party is for medical expenses. In my view, that is neither what the statute says nor what it does. According to the plain language of the statute, the legislature envisioned both that a beneficiary could have a private attorney representing her in an action against a third party, see N.C.G.S. \u00a7 108A-57(a) (referring to \u201c[a]ny attorney retained by the beneficiary of the assistance\u201d), and that for most settlements, damages for medical expenses would be prorated among the various providers, see id. (requiring the recipient\u2019s attorney to \u201cdistribute to the Department the amount of assistance paid by the Department on behalf of or to the beneficiary, as prorated with the claims of all others having medical subrogation rights or medical liens against the amount received or recovered\u201d). Thus, the General Assembly itself recognized that either stipulations by the parties or evidentiary hearings would be necessary to determine the amount of recovery by DMA and others seeking reimbursement for payment of medical expenses. Moreover, as with other lien statutes,' see, e.g., N.C.G.S. \u00a7 97-10.2(f) (2005) (Workers\u2019 Compensation Act), the General Assembly acknowledged that the beneficiary\u2019s attorney would likely be entitled to a large percentage of the settlement as a contingent fee; as such, the one-third cap represents a reasonable ceiling on the amount paid to DMA while also ensuring that the beneficiary would still recover a meaningful proportion of the settlement.\nThis reading of the statute is supported by the public policy rationale that underpins the federal requirements for \u201cassignment laws\u201d adopted by the states to seek reimbursement for the Medicaid payments they make. Such assignments prevent \u201cdouble recovery\u201d by a beneficiary: because the beneficiary is required to repay Medicaid from the medical expenses portion of his settlement with a third-party tortfeasor, he does not keep both the State\u2019s money and damages recovered from the tortfeasor. However, both the federal and state statutory schemes rely on the beneficiary \u2014 not the State or county \u2014 to bring a civil action against the third-party tortfeasor. Indeed, without the beneficiary\u2019s action to bring the suit, the State may enjoy no recovery at all for the Medicaid payments it made to the beneficiary as a result of the injury or accident. Thus, the State seeks to encourage beneficiaries to bring such suits. Accordingly, the statute is designed to protect the State\u2019s interest in having the suit brought by providing an incentive for the beneficiary to bring the suit \u2014 namely, by safeguarding some portion of the settlement for the beneficiary rather than allowing all of the proceeds to be paid to the attorneys and to DMA and other medical lienholders. Without this guarantee of some return, beneficiaries would be unlikely to go through the time and inconvenience associated with pursuing a civil action, and the State or DMA would be left with no recovery at all.\nApplication of N.C.G.S. \u00a7 108A-57(a) in a manner consistent with this rationale likewise comports with the reasoning relied upon by the United States Supreme Court in Ahlborn to ensure that a state Medicaid agency does not \u201cforce an assignment of, or place a lien on, any other portion of [the beneficiary\u2019s] property\u201d or settlement proceeds designated to compensate a beneficiary for other types of damages. 547 U.S. at 284, 164 L. Ed. 2d at 474. Specifically, Ahlborn compels our State to apply N.C.G.S. \u00a7 108A-57(a) in compliance with the following language:\nFederal Medicaid law does not authorize [the state agency] to assert a lien on [a beneficiary\u2019s] settlement in an amount exceeding [the pro rata portion designated as reimbursement for medical payments made], and the federal anti-lien provision affirmatively prohibits it from doing so. [The State\u2019s] third-party liability provisions are unenforceable insofar as they compel a different conclusion.\nId. at 292, 164 L. Ed. 2d at 479. Thus, I would not find that N.C.G.S. \u00a7 108A-57(a) violates the federal anti-lien provisions on its face, as it could be applied to factual situations in which the parties have stipulated, or an evidentiary hearing has determined, how to allocate the settlement proceeds among medical expenses and other damages. Nevertheless, I conclude that here, when the settlement proceeds have not been so allocated, the only way to ensure that the application of the statute complies with Ahlbom is to provide for such an allocation.\nI would therefore reverse the Court of Appeals with instructions to remand to the trial court to hold an evidentiary hearing to ensure that the DMA lien is not applied to settlement proceeds aside from those designated to reimburse medical expenses.\nJustices BRADY and TIMMONS-GOODSON join in this dissenting opinion.\n. Because the settlement agreements here are confidential and held under seal, I use only hypothetical figures.\n. Although neither party has raised the issue of unconstitutional impairment of contract before this Court, I also believe the majority\u2019s interpretation could lead to the conclusion that N.C.G.S. \u00a7 108A-57(a) violates the Contract Clause of the United States Constitution by overriding the intentions of parties to private contract. See U.S. Const, art. I, \u00a7 10, cl. 1 (\u201cNo state shall. . . pass any . . . law impairing the obligation of contracts ....\u201d); Adair v. Orrell\u2019s Mut. Burial Ass\u2019n, 284 N.C. 534, 538, 201 S.E.2d 905, 908 (\u201cAny law which enlarges, abridges or changes the intention of the parties as indicated by the provisions of a contract necessarily impairs the contract....\u201d) (citations omitted), appeal dismissed, 417 U.S. 927 L. Ed. 2d 231 (1974).\nI recognize that such impairment is sometimes permissible \u201cto protect the general welfare of its citizens, so long as such impairment is reasonable and necessary to serve an important public purpose.\u201d Bailey v. State, 348 N.C. 130, 151, 500 S.E.2d 54, 66 (1998) (citing U.S. Trust Co. of N.Y. v. New Jersey, 431 U.S. 1, 25-26, 52 L. Ed. 2d 92, 111-12 (1977)). However, \u201c \u2018a State is not free to impose a drastic impairment when an evident and more moderate course would serve its purposes equally well.\u2019 \u201d Id. at 152, 500 S.E.2d at 67 (quoting U.S. Trust, 431 U.S. at 31, 52 L. Ed. 2d at 115). Moreover, \u201c \u2018[i]n applying this standard,... complete deference to a legislative assessment of reasonableness and necessity is not appropriate because the State\u2019s self-interest is at stake.\u2019 \u201d Id. at 151, 500 S.E.2d at 66 (quoting U.S. Trust, 431 U.S. at 25-26, 52 L. Ed. 2d at 112 (alteration in original)).\n. As noted by the Supreme Court in Ahlbom, the risk of settlement manipulation, also discussed by Judge Steelman in his dissent in Ezell, 175 N.C. App. at 65-66, 623 S.E.2d at 85, \u201ccan be avoided either by obtaining the State\u2019s advance agreement to an allocation or, if necessary, by submitting the matter to a court for decision.\u201d Ahlborn, 547 U.S. at 288, 164 L. Ed. 2d at 476. In addition, the United States Supreme Court disavowed this rationale \u2014 that was the basis of Judge Steelman\u2019s dissent, which we adopted, 360 N.C. 529, 631 S.E.2d 131 \u2014 and observed that \u201cthere [is] a countervailing concern that a rule of absolute priority might preclude settlement in a large number of cases, and be unfair to the recipient in others.\u201d Ahlborn, 547 U.S. at 288, 164 L. Ed. 2d at 476. For this reason too I would disagree with the majority opinion\u2019s conclusion that Ezell is still good law.", "type": "dissent", "author": "Justice HUDSON" } ], "attorneys": [ "Wishart, Norris, Henninger & Pittman, P.A., by Pamela S. Duffy and Molly A. Omdorff for tmstee-appellant Charlie D. Brown.", "Roy Cooper, Attorney General, by Susannah P. Holloway, Assistant Attorney General, for intervenor-appellee North Carolina Department of Health and Human Services, Division of Medical Assistance.", "Glenn, Mills, Fisher & Mahoney, P.A., by Carlos E. Mahoney, Counsel for North Carolina Academy of Trial Lawyers, amicus curiae." ], "corrections": "", "head_matter": "KATELYN ANDREWS, a minor, through her Guardian ad Litem, DAVID ANDREWS; and DAVID ANDREWS and ANDREA ANDREWS, individually v. VANESSA P. HAYGOOD, M.D., individually; CENTRAL CAROLINA OBSTETRICS AND GYNECOLOGY, P.A., a North Carolina Corporation; THE WOMEN\u2019S HOSPITAL OF GREENSBORO, a North Carolina Not-for-Profit Corporation; KIM RICHEY, R.N., individually; and JENNIFER DALEY, R.N., individually v. NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF MEDICAL ASSISTANCE, Intervenor\nNo. 57A07-2\n(Filed 12 December 2008)\nSubrogation\u2014 Medicaid \u2014 medical malpractice settlement\u2014 reimbursement for prior medical expenditures\nThe trial court did not err in a medical malpractice case by subrogating plaintiff\u2019s settlement proceeds to the North Carolina Division of Medical Assistance, subject to the one-third statutory limitation, because: (1) Ahlbom, 547 U.S. 268 (2006), does not mandate a judicial determination of the portion of a settlement from which the State may be reimbursed for prior medical expenditures, but instead the United States Supreme Court left to the States the decision on the measures to employ in the operation of their Medicaid programs; (2) North Carolina employs an alternative statutory procedure under N.C.G.S. \u00a7 108A-57(a) which allows total reimbursement to the State only when the amount of assistance previously paid for medical expenses is one-third of plaintiff\u2019s settlement or less; if the amount of the State\u2019s claim exceeds one-third of the recovery, our statute limits reimbursement to one-third of the settlement; and plaintiffs are free to negotiate a settlement with the State for a lien amount less than that required by our statutes; and (3) N.C.G.S. \u00a7 108A-59(a) provides a reasonable framework that comports with the requirements of federal Medicaid law as interpreted by Ahlbom.\nJustice HUDSON dissenting.\nJustices BRADY and TIMMONS-GOODSON join in dissenting opinion.\nAppeal pursuant to N.C.G.S. \u00a7 7A-30(2) from the decision of a divided panel of the Court of Appeals, 188 N.C. App. 244, 655 S.E.2d 440 (2008), affirming an order entered on 27 July 2006 by Judge Steve A. Balog in Superior Court, Alamance County. On 10 April 2008, the Supreme Court allowed appellant\u2019s petition for discretionary review of additional issues. Heard in the Supreme Court 13 October 2008.\nWishart, Norris, Henninger & Pittman, P.A., by Pamela S. Duffy and Molly A. Omdorff for tmstee-appellant Charlie D. Brown.\nRoy Cooper, Attorney General, by Susannah P. Holloway, Assistant Attorney General, for intervenor-appellee North Carolina Department of Health and Human Services, Division of Medical Assistance.\nGlenn, Mills, Fisher & Mahoney, P.A., by Carlos E. Mahoney, Counsel for North Carolina Academy of Trial Lawyers, amicus curiae." }, "file_name": "0599-01", "first_page_order": 677, "last_page_order": 691 }