Is the Medicaid Program a “Victim” Entitled to Restitution?

October 22, 2009 | Erin Herbold

The defendant pled guilty to assault causing bodily injury and was sentenced to 60 days in jail, given probation, fined and ordered to pay $1266 in Medicaid expenditures triggered by the victim’s injuries. The defendant appealed the portion of the sentencing order requiring him to pay for the victim’s Medicaid expenses.  

The issue was whether the trial court judge had the authority to order repayment of Medicaid expenses as restitution.  Under Iowa law, a trial court judge may order restitution payments for the victim’s pecuniary damages and payments to the clerk of court for fines, penalties, surcharges… and “restitution to public agencies.” Iowa Code §910.2.  Medicaid expenditures do fall under the payment to the Clerk of Court provision for Restitution, but the real question was whether the Medicaid program was a victim of the defendant’s injuries. While the court noted that there have been prior instances where the state has been a victim of a crime and, consequently, is entitled to Restitution payments, the court also noted that the Medicaid program could only qualify as a victim if it suffered a “direct economic loss as the result of a crime.” 

Based upon the court’s interpretation of the statute, they determined that the legislature did not intend Medicaid to be a victim. Restitution payments must first be made to a victim, then to the Clerk of Court, then to a crime victim compensation program, and finally to public agencies. If the court allowed Medicaid to rise to the level of “victim” status, then Medicaid could hypothetically be paid before the actual victim of the crime.  That, the court concluded, wouldn’t be appropriate.  Thus, the Medicaid program is not a “victim” entitled to restitution.  State v. Stewart, 778 N.W.2d 62 (Iowa Ct. App. 2009).