The Attorney General has concluded that legal advice provided to the Government on nursing home fees was "sound, accurate and appropriate".
Rossa Fanning SC also found that there was no positive legal duty to make retrospective payments on the Disabled Persons Maintenance Allowance
The 30-page report was considered by the Cabinet this morning and then studied further by individual ministers, before being published this evening.
Ministers Stephen Donnelly and Heather Humphreys have been tasked by the Cabinet to consider the report in detail, and come back within three months on any further action.
The report is focused on pre-2005 private nursing home charges, and pre-2007 Disabled Persons Maintenance Allowances.
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No decision was taken on whether there will be compensation scheme, operating on an ex-gratia basis, for those affected by withholding of disability allowance.
The Attorney General expressed the view that the public interest is the only interest - and that must include taxpayers.
Mr Fanning found there was a "bona fide legal defence" for the State to use against claims for nursing home charges for medical card patients in private care.
He found that the Government acted "prudently".
In a statement this evening, Sinn Féin health spokesperson David Cullinane said for "far too long" governments have taken an "aggressive and combative approach to those who have been wronged by the State".
"Successive governments put in place callous and calculated strategies to deny the most vulnerable their rights," Mr Cullinane said.
"More important than the report from the Attorney General, is that we now get full disclosure and openness from the Government and from those who were in positions of power, including former health ministers who must come before the Health Committee."
Social Democrats co-leader Róisín Shortall said: "It is no surprise that the AG provides a full-throated defence of a legal strategy that was adopted and implemented by successive governments over many years.
"However, the report is blinkered. It finds that cost containment is the paramount concern of the State in legal proceedings.
"The legal rights and entitlements of the most vulnerable in our society are, evidently, a distant second in the priority stakes," Ms Shortall said.
"Even in the case of the illegal removal of disability payments from extremely vulnerable people in residential care, the AG finds there was no legal duty to repay funds that were removed without any valid legal authority.
"The AG may be correct that this is the strict legal position, but governments must take a broader view.
"It is the job of the government to defend the rights and entitlements of this country's citizens - not ride roughshod over them in the interests of financial expediency".
Labour Leader Ivana Bacik said that it has not been explained why it was 'prudent' to settle so many cases if the State had a viable defence.
She said the Attorney General's report conflates the interests of the Government with that of the State and it also places undue and inaccurate emphasis on Government policy rather than legislation as the basis for spending decisions.
Last week, the Government maintained that its policy has been that medical card holders were not eligible for private nursing home fees.
But the State has settled some legal cases with financial payouts on the issue.
Separately, the Government conceded that the State did face issues in relation to people who were in receipt of a disability allowance that was not paid to them when they went into long-term care.
In the Dáil last week, Taoiseach Leo Varadkar said that the legal advice regarding the disability allowances was that the State "did not have a leg to stand on".
The Department of Health is currently doing a report on the issues based on looking back over its files.
The disability allowances issues, which was reported on RTÉ's Prime Time last week, related to the 1970s, 1980s and 1990s.
Since 2007, the disability allowance has been paid in full to individuals in long-term nursing care, according to the Government.
Additional reporting David Murphy