Tuesday, August 2, 2005
State Agency Cannot Enforce Medi-Cal Lien Against Wrongful Death Recovery, Supreme Court Says
By a MetNews Staff Writer
The state cannot enforce a Medi-Cal lien against a wrongful death settlement or judgment that does not, and by law cannot, include the medical expenses for which the state seeks reimbursement, the Supreme Court ruled yesterday.
In a unanimous decision, with Justice Joyce L. Kennard writing the opinion, the justices reversed a ruling of the Fourth District Court of Appeal’s Div. Two and held that the state cannot recover more than $66,000 it is seeking from the family of Elan J. Fitch.
Fitch, a diesel mechanic, died in September 1993 of cancer. Before his death, he brought a workers’ compensation claim, alleging that the cancer was a result of exposure to chemicals while working for the Southland Corporation.
Fitch’s wife brought a products liability wrongful death action in 1995 against several defendants. All except Select Products Company, manufacturer of a coating product allegedly used by Fitch in his work, settled or were dismissed prior to trial.
While the suit was pending, the Southland Corporation settled the workers’ compensation claim. Consequent to that settlement, it agreed to pay the state $40,000 of the $106,000 it was claiming for the decedent’s medical care, with the state Department of Health Services reserving the right to seek the rest out of any recovery in the wrongful death action.
Select won a summary adjudication in that action, barring Dianne Fitch from suing on her own behalf, or as personal representative of her husband’s estate, based on the statute of limitations. The action went to trial, however, and resulted in a judgment in favor of the couple’s three minor children in the amount of $682,600.
Ruling on a post-trial motion, San Bernardino Superior Court Judge Christopher Warner struck the Medi-Cal lien, saying that since medical expenses were not an element of the wrongful death claim, the statute allowing such expenses to be recovered out of a tort recovery did not apply.
The Court of Appeal reversed, but Kennard yesterday said the trial judge was correct.
The justice cited Welfare and Institutions Code Sec. 14124.71, stating that “[w]hen benefits are provided to a beneficiary ... because of an injury for which another person is liable ... the director shall have a right to recover from such person ... the reasonable value of the benefits so provided.”
Emphasizing the references to “another person” and “such person,” the justice explained:
“Because the damages awarded in a wrongful death action are compensation for the harm to the survivors rather than to the decedent, and because those damages do not include medical expenses incurred in treating the decedent, to allow the DHS to recover the decedent’s medical expenses from the wrongful death damages would reduce those damages below the amount needed to fully compensate the survivors for the harm done to them Such a recovery would not be from the third party tortfeasor, but from the decedent’s innocent survivors...and therefore it is not statutorily authorized.”
The case is Fitch v. Select Products Company, 05 S.O.S. 3954.
Copyright 2005, Metropolitan News Company