Cargill v. State, Department of Health

967 P.2d 999, 1998 Wyo. LEXIS 157, 1998 WL 774693
CourtWyoming Supreme Court
DecidedNovember 9, 1998
DocketNo. 97-315
StatusPublished
Cited by13 cases

This text of 967 P.2d 999 (Cargill v. State, Department of Health) is published on Counsel Stack Legal Research, covering Wyoming Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cargill v. State, Department of Health, 967 P.2d 999, 1998 Wyo. LEXIS 157, 1998 WL 774693 (Wyo. 1998).

Opinion

TAYLOR, Justice, Retired.

Appellant contests the district court’s order awarding the Department of Health full reimbursement, from appellant’s settlement with a third party, of benefits paid by Medicaid on her behalf. Finding no error in the district court’s order, we affirm.

I.ISSUES

Appellant, Linda Cargill (Cargill), seeks review of the following issues:

I. Can the Department of Health Care Financing enforce a medical expense lien without actually filing the lien?
II. When the plain language of the applicable statute states that the Department’s lien “shall be reduced by the attorney’s fees and expenses authorized pursuant to this section,” Wyo. Stat. § 42-M-202(f), may the Department claim that it is entitled to the full amount of its lien and further reduce the Plaintiffs settlement?
III. Do the Department’s regulations violate the Constitution’s doctrine of separation of powers, in that they exceed the authority delegated by the Wyoming Legislature, such that an agency of the executive branch is encroaching on the legislative branch?

Appellee, the Department of Health, Division of Health Care Financing (the Department), states the issues as:

I. Does the Department of Health, Division of Health Care Financing have the right to recover against proceeds of a settlement for medical claims it paid on behalf of a Medicaid recipient under Wyo. Stat. §§ 42-4-201 et seq.?
II. Did the district court correctly order settlement proceeds to the Division of Health Care Financing in accordance with Wyo. Stat. §§ 42-4-201, 42-4-202, and Medicaid Rules, Chapters 4 and 35?
III.Are duly promulgated agency rules regarding third party liability and Medicaid benefit recovery unconstitutional because they violate the separation of powers doctrine?

II. FACTS

Cargill was burned by a home health care provider employed by St. John’s Hospital Home Care Services (St.John’s). Medicaid paid the expenses of Cargill’s medical treatment for her burns. Cargill filed a complaint against the health care provider and St. John’s, and entered into settlement negotiations with them. Under the terms of the settlement reached, $70,000.00 was to be placed in a special needs trust for Cargill’s benefit during her life, with the Department as remainderman. The settlement terms also provided that, in the event the trust was not established, the $70,000.00 was to be paid to Cargill immediately, “subject to the Medicaid lien claimed or which may be claimed by the State of Wyoming * * *.”

Cargill and St. John’s sought approval of their settlement agreement from the district court, and a hearing was scheduled. At this juncture, the Wyoming Attorney General was notified, for the first time, of Cargill’s complaint and the settlement negotiations. The attorney general was invited to participate in the hearing to approve the proposed settlement.1 The Department moved to intervene in the case, seeking disapproval of the special needs trust. The complaint in intervention also alleges that the Department paid $13,-579.69 for medical services related to Car-gill's burns. Intervention was granted over Cargill’s objection.

[1001]*1001At the healing, it was generally conceded that the law does not permit a special needs trust with a Medicaid recipient as lifetime beneficiary and the Department as remain-derman. Cargill turned, instead, to argue that the Department should not be reimbursed because it had not filed a lien statement to perfect its lien. Cargill also argued that, even if the Department is entitled to reimbursement without having perfected its lien, Wyoming statutes require that attorney’s fees and expenses be deducted from the lien amount, and since Cargill’s fees and expenses were higher than the Department’s lien, the Department should receive nothing.

The district court found that the special needs trust contemplated in the settlement agreement was not permitted by Wyoming law. The remainder of the settlement was approved. The district court also found that Wyoming statutes and Department rules and regulations require full reimbursement of Medicaid payments from the settlement proceeds, and ordered that the Department be fully reimbursed. Cargill appeals the reimbursement order.

III. STANDARD OF REVIEW

The crux of this case is whether Cargill is required to reimburse the Department, out of her $70,000.00 settlement with St. John’s, the $13,579.69 Medicaid paid for treatment of her burns. All three of Car-gill’s arguments against reimbursement require interpretation of statutory provisions enacted to ensure Medicaid benefit recovery when there is a liable third party. “Statutory interpretation is a question of law, so our standard of review is de novo. * * * If the conclusion of law is in accordance with the law, we affirm it; if it is not, we correct it.” May v. May, 945 P.2d 1189, 1191 (Wyo.1997) (citing Parker Land and Cattle Co. v. Wyoming Game and Fish Com’n, 845 P.2d 1040, 1042 (Wyo.1993)).

“We endeavor to interpret statutes in accordance with the Legislature’s intent. We begin by making an ‘ “inquiry respecting the ordinary and obvious meaning of the words employed according to their arrangement and connection.”’ Parker Land and Cattle Company v. Wyoming Game and Fish Commission, 845 P.2d 1040, 1042 (Wyo.1993) (quoting Rasmussen v. Baker, 7 Wyo. 117, 133, 50 P. 819, 823 (1897)). We construe the statute as a whole, giving effect to every word, clause, and sentence, and we construe together all parts of the statute in pari materia.”

State ex rel. Wyoming Workers’ Safety and Compensation Div. v. Bruhn, 951 P.2d 373, 376 (Wyo.1997) (quoting State Dept. of Revenue and Taxation v. Pacificorp, 872 P.2d 1163, 1166 (Wyo.1994)).

IV. DISCUSSION

Medicaid is funded jointly by the state and federal governments. Before a state can receive federal appropriations for Medicaid, a state plan must be approved by the federal Health Care Financing Administration. 42 U.S.C. § 1396; 42 C.F.R. § 430. Under federal law, the state plan must include provisions for collecting payments from liable third parties and reimbursement of those payments to Medicaid. States must require recipients to assign to the state any rights to recovery of payment of medical care from a liable third party. This assignment is a condition of eligibility to receive Medicaid benefits. 42 U.S.C. § 1396(k).

Wyoming’s compliance with this federal mandate is found at Wyo., Stat. §§ 42-4-201 — 42-4-208 (1997). Wyo. Stat.

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Bluebook (online)
967 P.2d 999, 1998 Wyo. LEXIS 157, 1998 WL 774693, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cargill-v-state-department-of-health-wyo-1998.