On 04/25/2016 BRUCE NUNEZ filed a Personal Injury - Medical Malpractice lawsuit against KEDREN COMMUNITY HEALTH CENTER. This case was filed in Los Angeles County Superior Courts, Stanley Mosk Courthouse located in Los Angeles, California. The Judge overseeing this case is CHRISTOPHER K. LUI. The case status is Pending - Other Pending.
Pending - Other Pending
Los Angeles County Superior Courts
Stanley Mosk Courthouse
Los Angeles, California
CHRISTOPHER K. LUI
KEDREN COMMUNITY HEALTH CENTER INC.
CITY OF LOS ANGELES
DOES 1 TO 30
STATE OF CALIFORNIA
MARKARIAN CHRISTOPHER V.
MARKARIAN CHRISTOPHER VREJ
BUTLER TIOSHA NICHOLE
DAVIS JOEL A.
KAMEL BRIAN PATRICK
12/28/2017: ORDER AND STIPULATION TO CONTINUE TRIAL, FSC [AND RELATED MOTION/DISCOVERY DATES] PERSONAL INJURY COURTS ONLY (CENTRAL DISTRICT)
1/17/2018: PLAINTIFF'S OPPOSITION TO DEFENDANT KENDREN COMMUNITY HEALTH CENTER, INC'S EX PARTE APPLICATION TO VACATE COURT'S PRIOR ORDER CONTINUING TRIAL; DECLARATION OF CHRISTOPHER V. MARKARIAN AND MEMORANDUM O
1/17/2018: Minute Order
3/29/2018: MOTION TO CONTINUE TRIAL AND ALL RELATED DATES
6/28/2018: Other -
6/28/2018: Other -
8/23/2018: DECLARATION OF ERIC A. FORSTROM IN SUPPORT OF PLAINTIFF'S OPPOSITION TO DEFENDANT KEDREN COMMUNITY HEALTH CENTER, INC.'S MOTION FOR SUMMARY JUDGMENT OR, IN THE ALTERNATIVE, SUMMARY ADJUDICATION
8/23/2018: DECLARATION OF SANDRA ARROYO PSYD.IN SUPPORT OF PLAINTIFF'S OPPOSITION TO DEFENDANT KEDREN COMMUNITY HEALTH CENTER, INC'S MOTION FOR SUMMARY JUDGMENT OR, IN THE ALTRNATLVE, SUMMARY ADJUDICATION
9/13/2018: REQUEST FOR DISMISSAL
9/14/2018: REQUEST FOR DISMISSAL
3/28/2019: Minute Order
5/4/2016: PROOF OF SERVICE SUMMONS
7/6/2017: ORDER AND STIPULATION TO CONTINUE TRIAL, FSC (AND RELATED MOTION/DISCOVERY DATES)
10/24/2017: ANSWER TO COMPLAINT
Notice of Ruling; Filed by Bruce Nunez (Plaintiff)Read MoreRead Less
at 08:30 AM in Department 4A, Christopher K. Lui, Presiding; Order to Show Cause Re: Dismissal - Not Held - Continued - Party's MotionRead MoreRead Less
Minute Order ( (Order to Show Cause Re: Dismissal)); Filed by ClerkRead MoreRead Less
at 08:30 AM in Department 4; Order to Show Cause Re: Dismissal - Held - ContinuedRead MoreRead Less
Minute Order ((Order to Show Cause Re: Dismissal)); Filed by ClerkRead MoreRead Less
ORDER TO SHOW CAUSE RE: DISMISSALRead MoreRead Less
Order to Show Cause re: Dismissal (Settlement); Filed by ClerkRead MoreRead Less
at 1:30 PM in Department 4; Hearing on Motion for Summary Judgment (Motion for Summary Judgment; Off Calendar) -Read MoreRead Less
Notice; Filed by Kedren Community Health Center Inc., (Defendant)Read MoreRead Less
Minute order entered: 2018-09-17 00:00:00; Filed by ClerkRead MoreRead Less
PROOF OF SERVICE SUMMONSRead MoreRead Less
ORDER AND STIPULATION TO CONTINUE TRIAL, FSC (AND RELATED MOTION/DISCOVERY DATES)Read MoreRead Less
[Proposed Order] and Stipulation to Continue Trial, FSC (and Related Motion/Discovery Dates) Personal Injury Courts Only (Central District); Filed by Kedren Community Health Center Inc., (Defendant)Read MoreRead Less
Answer; Filed by Kedren Community Health Center Inc., (Defendant)Read MoreRead Less
DEFENDANT, KEDREN COMMUNITY HEALTH CENTER, INC.'S ANSWER TO PLAINTIFF, BRUCE NUNEZ'S COMPLAINTRead MoreRead Less
PROOF OF SERVICE SUMMONSRead MoreRead Less
Proof-Service/SummonsRead MoreRead Less
ComplaintRead MoreRead Less
Complaint; Filed by Bruce Nunez (Plaintiff)Read MoreRead Less
Summons; Filed by Bruce Nunez (Plaintiff)Read MoreRead Less
Case Number: BC618038 Hearing Date: November 17, 2020 Dept: 28
Motion to Strike
Having considered the moving papers, the Court rules as follows. No opposing papers have been filed.
On April 25, 2016, Plaintiff Bruce Nunez (“Plaintiff”) filed a complaint against Defendants Kedren Community Health Center, Inc., City of Los Angeles, County of Los Angeles, and State of California. Plaintiff alleges negligence and premises liability in the complaint arising from falling from a window onto pavement on May 2, 2015.
On July 23, 2020, Plaintiff filed a motion to strike a Medi-Cal lien pursuant to United States Code, Title 42, section 1396 et seq. and California Welfare & Institutions Code section 14124.70 et seq.
Plaintiff asks the Court to strike a Medi-Cal lien because it is excessive considering Plaintiff’s $80,000.00 settlement of this action.
Under California Welfare and Institutions Code 14124.76, subdivision (a), “. . . . Recovery of the director’s lien from an injured beneficiary’s action or claim is limited to that portion of a settlement . . . that represents payment for medical expenses, or medical care, provided on behalf of the beneficiary. All reasonable efforts shall be made to obtain the director’s advance agreement to a determination as to what portion of a settlement . . . that represents payment for medical expenses, or medical care, provided of behalf on the beneficiary. Absent the director’s advance agreement as to what portion of a settlement . . . for medical expenses, or medical care, provided on behalf of the beneficiary, the matter shall be submitted to a court for decision. Either the director or the beneficiary may seek resolution of the dispute by filing a motion, which shall be subject to regular law and motion procedures. In determining what portion of a settlement . . . represents payment for medical expenses, or medical care, provided on behalf of the beneficiary and as to what the appropriate reimbursement amount to the director should be, the court shall be guided by the United States Supreme Court decision in Arkansas Department of Health and Human Services v. Ahlborn (2006) 547 U.S. 268 and other relevant statutory and case law.”
“In Ahlborn, the United States Supreme Court held that in seeking reimbursement ‘the State’s assigned rights extend only to recovery of payments for medical care.’ In response to Ahlborn, our Legislature amended the California statutes governing claims for reimbursements made by the Department for funds expended on behalf of injured parties by the Medi-Cal program. (Bolanos v. Superior Court (2008) 169 Cal.App.4th 744, 747 . . . .) Namely, from any settlement, judgment or award obtained by an injured party, the Department is limited to recovering payments it made for medical expenses. (§ 14124.76, subd. (a).) ‘In determining what portion of a settlement, judgment, or award represents payment for medical expenses, or medical care, provided on behalf of the beneficiary and as to what the appropriate reimbursement amount to the director should be, the court shall be guided by . . . Ahlborn . . . and other relevant statutory and case law.’ ‘[W]hen the settlement, judgment or award does not specify what portion thereof was for past medical expenses, an allocation must be made in the settlement, judgment or award that indicates what portion is for past medical expenses as distinct from other damages. The director’s recovery is limited to that portion of the settlement that is allocated to past medical expenses.’” (Aguilera v. Loma Linda University Medical Center (2015) 235 Cal.App.4th 821, 827 [citations omitted].)
“Settlements, however, are often not allocated between past medical expenses and other damages. This was the situation in Ahlborn. Thus, the parties in Ahlborn stipulated to the use of a formula (the Ahlborn formula) as an allocation method. . . . The Ahlborn formula is the ratio of the settlement to the total claim, when applied to the benefits provided by the Department. Expressed mathematically, the Ahlborn formula calculates the reimbursement due as the total settlement divided by the full value of the claim, which is then multiplied by the value of benefits provided. (Reimbursement Due = [Total Settlement ÷ Full Value of Claim] x Value of Benefits Provided.).” (Id. at pp. 827-828.)
“The fundamental point is that a settlement that does not distinguish between past medical expenses and other damages must be allocated between these two classes of recoveries. Without such an allocation, the principle set forth in Ahlborn, that the state cannot recover for anything other than past medical expenses, cannot be carried into effect.” (Bolanos, supra, 169 Cal.App.4th at p. 753.)
Plaintiff’s total settlement is $80,000.00. (Motion, pp. 5:8-5:10.) Plaintiff claims without that the full value of Plaintiff’s claim is between $1,600,000.00 and $2,000,000.00 (Motion, p. 3:21.). No evidence to support this . While Plaintiff has attached photographs to his moving papers, he provides no (i.e., a declaration). Absent evidence Plaintiff’s claim, the court has not basis upon which to perform the Ahlborn formula.
The motion is DENIED without prejudice.
Plaintiff is ordered to give notice of this ruling
The parties are directed to the header of this tentative ruling for further instructions.
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