Branson

Branson v. Sharp Healthcare, Inc.

Good Law
123 Cal. Rptr. 3d 462·193 Cal. App. 4th 1467·2011 Cal. App. LEXIS 379
Court of Appeal of CaliforniaMarch 30, 2011No. D056892California3,674 words

Opinion

Lead Opinion

McConnell, J.

The beneficiary of medical services under the California medical assistance program (Medi-Cal) is required to reimburse the State Department of Health Care Services (the Department) for the costs of medical care from a recovery obtained in a tort action against a third party liable for the beneficiary’s injuries. The Department’s claim, however, “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.” (Welf. & Inst. Code, 1 § 14124.76, subd. (a); see Arkansas Dept. of Health and Human Servs. v. Ahlborn (2006) 547 U.S. 268, 278 [ 164 L.Ed.2d *1471 459 , 126 S.Ct. 1752 ] (Ahlbom).) When a settlement of third party litigation is unallocated between categories of damages, such as medical costs, lost earnings, and pain and suffering, the trial court may determine the appropriate Medi-Cal lien amount by comparing the percentage of the settlement to the beneficiary’s total damages, and applying that percentage to the past medical costs for which the Department seeks reimbursement. (Lopez v. DaimlerChrysler Corp. (2009) 179 Cal.App.4th 1373, 1378 [ 102 Cal.Rptr.3d 285 ]…

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