Lomeli v. State Dep't of Health Care Servs.

249 Cal. Rptr. 3d 115, 36 Cal. App. 5th 817
CourtCalifornia Court of Appeal, 5th District
DecidedJune 25, 2019
DocketB290608
StatusPublished

This text of 249 Cal. Rptr. 3d 115 (Lomeli v. State Dep't of Health Care Servs.) is published on Counsel Stack Legal Research, covering California Court of Appeal, 5th District primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lomeli v. State Dep't of Health Care Servs., 249 Cal. Rptr. 3d 115, 36 Cal. App. 5th 817 (Cal. Ct. App. 2019).

Opinion

WILEY, J.

*818If you are needy and someone injures you, the government may pay for your medical care but later ask you for repayment if you get a large *819settlement from the tortfeasor. In California this is by way of Medi-Cal. Medi-Cal seeks repayment from people with settlements so it can provide care to others in need.

This case displays that situation. The trial court approved the existence and amount of the Medi-Cal settlement lien in this case. We affirm. Statutory citations are to the Welfare and Institutions Code.

I

We recount the main facts, which are undisputed.

Ethan Lomeli's guardian sued medical care providers for his catastrophic birth injuries. Through the Medi-Cal system, the Department of Health Care Services paid for his care before and during his lawsuit. Lomeli settled with defendants for $4 million. The Department moved to impose a $ 267,159.60 lien on this settlement. The trial court granted this motion. Lomeli appeals this May 23, 2018 order.

II

Federal law does not block the Department's lien. Our review of this legal question is independent.

Lomeli argues to the contrary, saying sections 14124.72 and 14124.76 violate the *117Supremacy Clause of the federal constitution. Lomeli's argument relies solely on an analysis from the dissent in Tristani ex rel. Karnes v. Richman (3rd Cir. 2011) 652 F.3d 360, 379-387 ( Tristani ). The trial court went with the Tristani majority. So do we. At pages 367-375, the Tristani majority correctly determined federal law does not prohibit liens like this one.

Briefly, the Tristani debate is this. The Tristani majority held two provisions of the Social Security Act did not bar state Medicare liens. To effectuate Congress's goals in enacting the federal Medicare program, the Tristani majority interpreted federal statutes as containing implied exceptions to provisions that otherwise seemed to bar the liens. (See Tristani , supra , 652 F.3d at p. 370.) The dissent agreed some implicit federal exception to these two Social Security statutes did exist. ( Id. at pp. 384 (dis. opn. of Pollack, J.) ["must constitute an explicit exception"] & 385 (dis. opn. of Pollack, J.) ["a limited implied exception must be read into the anti-recovery provision"].) The dissent argued this implicit exception was narrower than the majority's expression of it.

The Tristani majority analysis is better for two reasons.

*820First, a desire to effectuate the legislative purpose drove the majority's analysis.

"The dominant mode of statutory interpretation over the past century has been one premised on the view that legislation is a purposive act, and judges should construe statutes to execute that legislative purpose. This approach finds lineage in the sixteenth-century English decision Heydon's Case , which summons judges to interpret statutes in a way 'as shall suppress the mischief, and advance the remedy.' " (Katzmann, Judging Statutes (2014) p. 31.)

California courts follow this dominant mode. In our state, we must interpret words to promote rather than to defeat the general purpose of a statute. Suppose the language of a statute is reasonably susceptible of two constructions. If one would produce results that are reasonable, fair, and harmonious with the statute's manifest purpose, and another would produce absurd consequences, we must adopt the former construction. ( Department of Motor Vehicles v. Industrial Acc. Com. (1939) 14 Cal.2d 189, 195, 93 P.2d 131.) Like the Tristani majority, our fundamental task is to ascertain the intent of the lawmakers to effectuate the purpose of the statute. (E.g., Apple Inc. v. Superior Court (2013) 56 Cal.4th 128, 135, 151 Cal.Rptr.3d 841, 292 P.3d 883.)

Federal and California state law agree on this point: read a statute to effectuate its purpose. The Tristani majority correctly discerned Congress's purpose: to ensure Medicaid beneficiaries do not receive a windfall by recovering medical costs they did not pay. (See Tristani , supra , 652 F.3d at pp. 371-373.)

Second, the Tristani majority included common sense and practical reasoning in its analysis. (See id. at pp. 374-375.) Common sense and practical reasoning are attractive in legal analysis.

Lomeli adds nothing to the Tristani debate and, except for our agreement with that majority's careful and correct analysis, neither do we.

III

Collateral estoppel does not bar this May 23, 2018 lien. Again our review is independent.

Lomeli incorrectly claims the trial court decided something about the Medi-Cal lien by approving his minor's compromise on August 30, 2016. Before that 2016 approval, however, Lomeli informed the court his pending petition did not "address the *118[Medi-Cal] lien at all." Lomeli's representation *821was correct: the August 30, 2016 order did not address the Medi-Cal lien at all. The trial court decided about the Medi-Cal lien only much later, on May 23, 2018.

Lomeli's collateral estoppel argument is wrong. Collateral estoppel is about how an earlier decision affects a later one. There must be two decisions before this doctrine can be pertinent. In this case there was only one decision, which was on May 23, 2018. There was no earlier decision of relevance.

The trial court order of August 30, 2016 did not decide anything about the Medi-Cal lien. The text of this order confirms Lomeli's representation that it did not decide the Medi-Cal lien in any way. The order is on Judicial Council form MC-351. Lomeli's lawyer typed his name and address in the heading on page one.

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Bluebook (online)
249 Cal. Rptr. 3d 115, 36 Cal. App. 5th 817, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lomeli-v-state-dept-of-health-care-servs-calctapp5d-2019.