a medicaid defendant wins an accident settlement, must medicaid be reimbursed from his settlement

Medicaid may have a right to reimbursement for medical costs it paid to treat accident injuries.  So, if a medicaid reicipient is injured in an accident and requires medicaid to pay his/her treatment bills, then medicaid would have a lien against any recovery obtained by the injured party. To me, when you say that a "medicaid Defendant" won, that means that he/she succeeded and thus does not have to pay the plaintiff.  A defendant who wins, typically does not receive any payment and thus there would be nothing to be paid to medicaid.  Medicaid is to be reimbursed only if the medicaid recipient receives payment from the person causing the accident.