State ex rel. Department of Health, Division of Health Care Financing v. Dairyland Insurance Co.

11 P.3d 348, 2000 Wyo. LEXIS 189, 2000 WL 1222051
CourtWyoming Supreme Court
DecidedAugust 29, 2000
DocketNo. 99-331
StatusPublished
Cited by4 cases

This text of 11 P.3d 348 (State ex rel. Department of Health, Division of Health Care Financing v. Dairyland Insurance Co.) 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
State ex rel. Department of Health, Division of Health Care Financing v. Dairyland Insurance Co., 11 P.3d 348, 2000 Wyo. LEXIS 189, 2000 WL 1222051 (Wyo. 2000).

Opinion

GOLDEN, Justice.

The primary issue in this appeal is whether the State is entitled to recover Medicaid benefit payments from a third-party settlement occurring before the applicant is ruled eligible for Medicaid benefits. Appellant Department of Health, Division of Health Care [350]*350Financing (State) paid Medicaid benefits and then sought recovery for those benefits from Appellee Dairyland Insurance Company and their insured, Billy Joe Wright. The district court granted summary judgment to Dairy-land Insurance Company, denied the State's motion for summary judgment, and dismissed the complaint against Wright.

We affirm the order of the district court.

ISSUES

The State presents these issues for our review:

I. Did the district court err in denying the state's claim for third-party reimbursement under Wyoming's Medicaid Statutes?
II. Did the district court err in dismissing the claim for relief against Billy Joe Wright?

Dairyland states the sole issue as:

Was the district court correct in granting Dairyland's Motion for Summary Judgment, denying the State's Motion for Summary Judgment and dismissing the State's Complaint as the State was not entitled to third-party reimbursement under the Wyoming Medical and Assistance Service Act, Wyo. Stat. § 42-4-101 through § 424-207 (1994 ed.)?

FACTS

On January 20, 1994, Sylvia Knapp (Knapp) was seriously injured when she was struck by a vehicle driven by the insured of Dairyland, Billy Joe Wright,. The parties have stipulated that she applied for Supplemental Social Security Income (SST) in February of 1994, and that approval for SSI automatically made her eligible for Medicaid, a federal program that provides medical benefits. On May 28, 1994, while represented by an attorney, Knapp signed a "Release Of All Claims" and settled her case against Wright for the policy limits of $25,000 in damages and for $5,000 under the policy's medical benefits.

Knapp was determined to be eligible for SSI on July 26, 1994, and eligible for Medicaid on August 8, 1994, under the Wyoming Medicaid Program. Her eligibility was made retroactive to February 1, 1994, and in August and October of 1994, Wyoming Medicaid paid over $12,000.00 in medical assistance on Knapp's behalf. On December 14, 1994, Consultec, Inc., the State's agent, contacted Dairyland about the settlement and was advised of the settlement amount and told that the settlement was not for medical expenses, but for general damages such as pain and suffering.1

In 1999, the State filed suit against Dairy-land for reimbursement of its Medicaid expenditures. The suit included a claim for relief against Wright, but he was never served. Summary judgment was granted in favor of Dairyland, and the claim against Wright was dismissed with prejudice. This appeal followed.

DISCUSSION

Standard of Review

Summary judgment is appropriate if no genuine issues of material fact exist and the prevailing party is entitled to judgment as a matter of law. Terry v. Pioneer Press, Inc., 947 P.2d 273, 275 (Wyo.1997); W.R.C.P. 56(c). Where the case only involves questions of law, summary judgment allows parties to forgo a formal trial. England v. Simmons, 728 P.2d 1137, 1141 (Wyo.1986). "We review a grant of summary judgment deciding a question of law de movo and afford no deference to the district court's ruling." Blagrove v. JB Mechanical, Inc., 934 P.2d 1273, 1275 (Wyo.1997).

Kirby v. NMC/Continue Care, 993 P.2d 951, 952-583 (Wyo.1999)

The State contends that it is entitled to recover from Dairyland under the Wyoming Medical Assistance and Services Act, Wyo. Stat. Ann. §§ 424-101 through 42-4-208.

[351]*351Statutory 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. 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. 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.

Cargill v. State, Dept. of Health, Div. of Health Care Financing, 967 P.2d 999, 1001 (Wyo.1998) (citations and quotations omitted).

Wyoming Medical Assistance and Services Act

Conceding that Knapp was not a recipient of Medicaid at the time of the settlement, the State nevertheless contends that, under both federal and state law, Dairyland had a duty to notify it of the settlement because Knapp was a recipient at the time that the State was seeking reimbursement. We have previously described the Medicaid program:

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. § 1896; 42 C.E.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. § 18396(k).
Wyoming's compliance with this federal mandate is found at Wyo. Stat. §§ 42-4-201-42-4-208.... Wyo. Stat, § 42-4-201(a) clearly and succinctly reiterates federal law and states the intent of the Wyoming legislature:
If a recipient covered by this chapter receives an injury under cireumstances creating a legal lability in some third party, the recipient shall not be deprived of any medical assistance for which he is entitled under this chapter. He may also pursue his remedy at law against the third party. If the recipient recovers from the third party in any manner, including judgment, compromise, settlement or release, the state is entitled to be reimbursed for all payments made, or to be made, on behalf of the recipient under this chapter.
There can be no clearer statement that Wyoming's legislature intended the Department be fully reimbursed for Medicaid payments made on behalf of a recipient who recovers those payments from a liable third party.

Cargill, 967 P.2d at 1001-02.

Statutory Notification Obligations

"Upon signing an application for medical assistance ..., an applicant assigns to the department any right to medical support or payment for medical expenses....

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11 P.3d 348, 2000 Wyo. LEXIS 189, 2000 WL 1222051, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-department-of-health-division-of-health-care-financing-v-wyo-2000.