Tentative Rulings

Case Number: BC585574    Hearing Date: August 10, 2020    Dept: 78

Superior Court of California

County of Los Angeles

Department 78

As to Plaintiff Daniel Corona’s Motion to Determine DHCS Lien Claim: the Court finds that DHCS’s requested lien amount is reasonable. DHCS is to recover on its lien in the amount of $229,696.73.

Factual Background

This is a medical negligence (wrongful life) case. Plaintiff Daniel Corona (“Corona”) (here acting through his Guardian ad Litem and mother, Rebecca Gutierrez (“Gutierrez”)) alleges that Defendants, a series of physicians and medical providers, acted negligently in offering care to Corona, resulting in a number of pre-birth, birth, and post-birth injuries. (Complaint at pp. 2–3.)

procedural history

Corona filed his Complaint on June 24, 2015, alleging a single cause of action for general negligence.

On March 23, 2017, this court granted David Miller’s Motion for Summary Judgment.

On August 16, 2017, this court granted White Memorial Hospital’s Motion for Summary Judgment.

Defendant Ronald B. Johnson (“Johnson”) was added as Doe defendant 1 on February 9, 2018.

Johnson filed an Answer on April 12, 2018.

On November 14, 2018, this Court granted Johnson’s Motion for Summary Judgment.

On April 16, 2019, this Court granted the Petition for Minor’s Compromise.

On October 16, 2019, an opinion from the Court of Appeal was received, affirming the Court’s granting of the MSJ in favor of David Miller. On December 16, 2019, the remittitur was received.

On May 18, 2020, Plaintiff filed the instant Motion to Determine Lien Claim.

On July 27, 2020, Claimant California Department of Health Care Services filed an Opposition.

Discussion

1. Request for judicial notice

The court may take judicial notice of “official acts of the legislative, executive, and judicial departments of the United States and of any state of the United States,” “[r]ecords of (1) any court of this state or (2) any court of record of the United States or of any state of the United States,” and “[f]acts and propositions that are not reasonably subject to dispute and are capable of immediate and accurate determination by resort to sources of reasonably indisputable accuracy.” (Evid. Code § 452, subds. (c), (d), and (h).)

The Department asks this Court to take judicial notice of various Court filings, rulings, and orders in this case. These items are all subject to judicial notice, and the Court GRANTS these requests.

1. objections

The Department submits various objections to evidence submitted by Plaintiffs in support of their Motion. The Court OVERRULES all objections.

Plaintiffs submit various objections to evidence submitted by the Department. The Court SUSTAINS Objections Nos. 3, 9, 11, 14, and OVERRULES the remainder.

1. MOTION TO DETERMINE DHCS LIEN CLIAM

The California Department of Health Care Services (the “Department”) asserts that it paid for Corona’a’s medical care through the joint federal-state Medicaid program, Medi-Cal. Corona asserts thathe obtained a partial recovery of his settlements in his medical negligence action. The Department has demanded $231,865 in reimbursements.” (Motion at p. 7.) Instead, Corona argues that the Department’s claim should be $0. (Motion at p. 7.)

In a letter dated November 27, 2018, the Department stated as follows: “The Medi-Cal program has advanced the sum of $419,812.26 for medical services provided to DANIEL CORONA. […] Based on a settlement amount of $1,250,000.00, attorney’s fees of $254,939.00 and litigation costs of $128,179.91, the [Department] will accept $271,810.01 as payment for Medi-Cal’s personal injury lien.” (P. Evid., Exh. 6.)

On January 17, 2019, the Department sent an updated letter: “The Medi-Cal program has advanced the sum of $358,117.51 for medical services provided to DANIEL CORONA. […] Based on a settlement amount of $1,250,000.00, attorney’s fees of $254,939.00 and litigation costs of $128,179.91, the [Department] will accept $231,865.37 as payment for Medi-Cal’s personal injury lien.” (P. Evid., Exh. 7.)

Corona argues that the “federal Anti-Lien, Anti-Recovery, and Forced Assignment provisions prohibit California from asserting a lien against, or recovery from, the property of a Medicaid beneficiary.” (Motion at p. 10.)

In Opposition, the Department argues that case law and the anti-lien provisions do not prohibit the Department’s recovery. (Oppo. at pp. 8-11.) The Court agrees, although there are limitations to the Department’s recovery.

As the Court held in Lopez v. DaimlerChrysler Corp.  of not more than the amount the beneficiary recovers, after deducting the beneficiary's litigation expenses and attorney fees. (§§ 14124.74, 14124.78.) Recovery from Medicaid beneficiaries must be made in accordance with federal Medicaid law, because federal Medicaid law controls.” ()

Welfare & institutions Code Section 14124.76(a) provides: “Recovery of the director's lien from an injured beneficiary's action or claim is limited to that portion of a settlement, judgment, or award that represents payment for medical expenses, or medical care, provided on behalf of the beneficiary.” ()

In this case Plaintiffs agree with the Department that the past medical expenses were $358,118. (Motion at p. 9.) Under Welfare & Institutions Code section 14124.72, subdivision (d), “If the action or claim is brought by the beneficiary alone and the beneficiary incurs a personal liability to pay attorney's fees and costs of litigation, the amount of the director's lien that is reimbursed shall be reduced by 25 percent, which represents the director's reasonable share of attorney's fees paid by the beneficiary, and that portion of the cost of litigation expenses determined by multiplying the actual litigation expenses by the ratio of the amount reimbursed to the director as satisfaction of the director's lien, prior to deducting reasonable attorney's fees and litigation expenses, to the full amount of the settlement, judgment, or award.” (Welf. & Inst. Code, § 14124.72.)

For this case, $358,117.51 minus one quarter is $268,588.13. The Department states, now, that it is entitled to recover $229,709.90, but that it will accept $229,696.73. (Oppo. at pp. 13-14; Valdez Decl., ¶¶ 19-26, Exh. G.) Plaintiffs seek to reduce this amount to zero, largely based on calculations that include large future medical expenses. (Motion at p. 9.) Plaintiffs argue that the Department’s recovery is limited to only 9.08% percent of $358,118 (the requested amount) because Daniel’s damages, including future damages are $13,847,277 and his recovery of $1,250,000 is 9.08% of $13,13,847,277. (Motion at p. 20.) The Court does not agree that the caselaw supports these calculations, which in fact, seem backwards. If the Court were to include future costs in its calculations, the Department would be entitled to an even greater share of the recovery, based on the “assumption that it will be responsible for all or a substantial portion of plaintiff's future medical expenses.” (See, Lima v. Vouis (2009) 174 Cal.App.4th 242, 262.) In fact, the case generally recognizes that “lien recovery was limited to that portion of [Plaintiff’s] settlement proceeds that were meant to compensate her for past medical costs.” (Id. at 257.)

Accordingly, the Court finds that the Department’s requested lien amount is reasonable. The Department is to recover on its lien in the amount of $229,696.73.

DATED: August 10, 2020 ________________________________

Hon. Robert S. Draper

Judge of the Superior Court