Hill Ex Rel. Hill v. State, Department of Human Services

493 N.W.2d 803, 1992 Iowa Sup. LEXIS 433, 1992 WL 380600
CourtSupreme Court of Iowa
DecidedDecember 23, 1992
Docket91-1297
StatusPublished
Cited by12 cases

This text of 493 N.W.2d 803 (Hill Ex Rel. Hill v. State, Department of Human Services) is published on Counsel Stack Legal Research, covering Supreme Court of Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hill Ex Rel. Hill v. State, Department of Human Services, 493 N.W.2d 803, 1992 Iowa Sup. LEXIS 433, 1992 WL 380600 (iowa 1992).

Opinion

LAVORATO, Justice.

Johnie L. Hill — a minor — was injured in a motorcycle accident. He eventually received $1330.73 in medical assistance benefits from the Iowa department of human services for care and treatment of his injuries. He and his family eventually settled their claims against the tortfeasor for $20,-000.

The present declaratory judgment action is about the department’s right to recoup its subrogation claim for the $1330.73 from the settlement proceeds under Iowa Code section 249A.6 (1991). Because of a recent amendment to section 249A.6, the department believes it is entitled to recover all of the $1330.73. In denying the department’s motion for summary judgment, the district court ruled that under Iowa Code section 249A.6(4), the $1330.73 subrogation claim should first be reduced by any attorney fees and court costs the Hills incurred in collecting it. We agree with the district court and affirm.

In the motorcycle accident, Johnie sustained serious injuries to his left ankle and foot. Eventually Johnie’s case against the tortfeasor was settled for $20,000, the limits of the tortfeasor’s liability policy. Johnie had received $1330.f3 in Title XIX Medicaid assistance benefits from the department for the care and treatment of his injuries. In the settlement against the tortfeasor, this amount was allocated to medical expenses. There is no dispute that Johnie’s injuries exceeded this amount.

Once Johnie’s case was settled, the department demanded $1330.73 in subrogation under section 249A.6 for its medical assistance benefits to Johnie. Later the Hills brought this declaratory judgment action against the department. The suit alleges that under section 249A.6 the department should pay from its subrogation claim of $1330.73 reasonable attorney fees and costs incurred in procuring the settlement.

The department moved for summary judgment, claiming it was entitled to the full amount of its subrogation claim without any reduction for attorney fees and costs. The district court disagreed and denied the motion. The department appealed.

Summary judgment is proper under Iowa Rule of Civil Procedure 237 only when the record reveals no genuine issue of material fact and that the moving party is entitled to a judgment as a matter of law. Hofco, Inc. v. National Union Fire Ins. Co., 482 N.W.2d 397, 400 (Iowa 1992). There is no fact question if the only conflict is about the legal consequences flowing *805 from undisputed facts. Id. In these circumstances summary judgment is the proper vehicle to test the validity of a claim. Id. Because the facts here are undisputed, we need only decide whether the district court properly applied the law.

I. Before proceeding to the merits, we think it would be instructive to review the statutory history and ease law concerning Iowa Code section 249A.6. At common law the recipient of public assistance was not obligated to reimburse the State for assistance provided. State ex rel. Iowa Dep’t of Human Servs. v. Brooks, 412 N.W.2d 613, 614 (Iowa 1987). For this reason, the State could not sue recipients or others to recover amounts expended for the recipient. Id. As part of the Social Security Act, Congress established an entitlement program for the medically needy. 42 U.S.C. § 1396a(a); Brooks, 412 N.W.2d at 614. The program is a joint one between the federal government and the states. Under the program a state must enforce its right of subrogation against persons legally liable to the benefit recipient for medical expenses incurred as a result of that liability. 42 U.S.C. § 1396a(a)(25); Brooks, 412 N.W.2d at 614.

Iowa Code section 249A.6 was enacted to implement this requirement. As originally passed this provision provided in pertinent part:

When payment is made by the department for medical care or expenses through the medical assistance program on behalf of a recipient, the department is subrogated, to the extent of those payments, to all monetary claims which the recipient may have against third parties as a result of the medical care or expenses received or incurred.

Iowa Code § 249A.6(1) (1987).

In Brooks we were called upon to interpret section 249A.6 for the first time. We said that under the statutory scheme

the state proceeds down one of two avenues for the recovery of medical assistance benefits paid for an individual when the legal liability for the injury rests with another individual: (1) action directly against the tortfeasor; or (2) claim against the settlement or judgment recovered by the medical assistance recipient.

Brooks, 412 N.W.2d at 615.

In Brooks only the personal injury claim of the minor was submitted to the jury which returned a verdict for the minor in the amount of $200,000. The parents’ claim for medical expenses was not submitted. This claim, amounting to $24,198.14, consisted of the medical assistance benefits from the department. We concluded that the department was not entitled to be sub-rogated to the $200,000 verdict for its medical assistance benefits. In reaching that conclusion we said:

When a statute is clear on its face, we need not refer to rules of statutory construction to give the statute effect. The terms of Iowa Code section 249A.6 are clear: “... [T]he department is subro-gated ... to all monetary claims which the recipient may have against third parties as a result of the medical care or expenses received or incurred.” This language guided the department in its adoption of a rule that states: “The recipient ... shall refund to the department any settlement or payment received, that is intended to cover any medical expenses that would otherwise be paid by medical assistance.” In order for [the department] to be subrogat-ed, to a recipient’s recovery in a tort action, it must be intended that a portion of the recovery compensate the recipient for medical care and expenses.

Brooks, 412 N.W.2d at 616 (citations omitted).

Because the minor in Brooks asserted no claim against the tortfeasor for her medical expenses, we reasoned that no part of the recovery was intended to cover the medical expenses paid by the department. For this reason we concluded that the department had no chapter 249A subrogation right against the general judgment of $200,000 recovered for the minor’s personal injuries.

Our next encounter with Iowa Code section 249A.6 came in Scott v. State ex rel. Iowa Dep’t of Human Seros., 438 N.W.2d *806 834 (Iowa 1989). In Scott

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493 N.W.2d 803, 1992 Iowa Sup. LEXIS 433, 1992 WL 380600, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hill-ex-rel-hill-v-state-department-of-human-services-iowa-1992.