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The article discusses a court case of Lewis v. Alexander that was decided by the Third Circuit of the U.S. Court of Appeals and which the court stroked down of the decisions made by the U.S. district court based on a statute of Pennsylvania related to the restrictions imposed on the use of limited trust retention of postmortem accounts and pooled special needs trust accounts (PSNT) to 50 percent. The issues related to declaratory and injunctive relief in case of putative class action filed by several individuals are discussed. The challenges related to the comparability argument with reference to the U.S. Medicaid statutes are also discussed.

The article discusses a court case of E.M.A. v. Cansler as decided by the Fourth Circuit of the U.S. Court of Appeals, related to the application of portion of the trial of Arkanas Dept. of Health and Human Servs. v. Ahlborn, based on federal Medicaid law and statute of North Carolina for the recovery of full expenditures in case of personal injury. The exception in case of subrogation right, prohibition of liens in case of Medicaid rule and the valuation of tort cases are discussed. The issues related to the manipulation of settlements by the private parties for limiting subrogation recovery are also discussed.