Tye v. Upper Valley Med. Ctr.

2014 Ohio 2822
CourtOhio Court of Appeals
DecidedJune 27, 2014
Docket25997
StatusPublished

This text of 2014 Ohio 2822 (Tye v. Upper Valley Med. Ctr.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Tye v. Upper Valley Med. Ctr., 2014 Ohio 2822 (Ohio Ct. App. 2014).

Opinion

[Cite as Tye v. Upper Valley Med. Ctr., 2014-Ohio-2822.]

IN THE COURT OF APPEALS FOR MONTGOMERY COUNTY, OHIO

SCOTT TYE, et al. :

Plaintiffs-Appellants/ : C.A. CASE NO. 25997 Cross-Appellees v. : T.C. NO. 10CV9282

UPPER VALLEY MEDICAL CENTER, : (Civil appeal from et al. Common Pleas Court)

Defendants-Appellees/ : Cross-Appellants :

:

..........

OPINION

Rendered on the 27th day of June , 2014.

T. JEFFREY BEAUSAY, Atty. Reg. No. 0039436, 495 S. High Street, Suite 300, Columbus, Ohio 43215 Attorney for Plaintiff-Appellants/Cross-Appellees

PAUL W. McCARTNEY, Atty. Reg. No. 0040207, 600 Vine Street, Suite 2650, Cincinnati, Ohio 45202 Attorney for Defendants-Appellees/Cross-Appellants, Howard Kessler, DO, David Chauvin, DO and West Central Emergency Physicians, Inc.

DONOVAN, J. [Cite as Tye v. Upper Valley Med. Ctr., 2014-Ohio-2822.] {¶ 1} This matter is before the Court on the Notice of Appeal of Scott Tye,

filed

November 14, 2013, as well as the Notice of Cross-Appeal of Howard Kessler, DO; David

Chauvin, DO; and West Central Emergency Physicians, Inc. (collectively, “Defendants”).

The parties appeal from the trial court’s October 22, 2013 “Decision, Order and Entry in

regard to Plaintiffs’ Motion for Post Settlement Interest,” in which the trial court determined

that post settlement interest accrued on November 8, 2012, and not the date that the parties

reached a settlement agreement, namely July 21, 2012. We hereby modify the decision of

the trial court to reflect that postsettlement interest accrued as of July 21, 2012 on the cash

portion of the settlement. As modified, the trial court’s judgment will be affirmed.

{¶ 2} On November 29, 2010, Scott Tye, Barbara Tye, Matthew Tye and Joshua

Tye filed a medical malpractice complaint against multiple parties, namely individuals and

entities associated with the medical care of Scott Tye received in 2009 for a spinal epidural

abscess. The Defendants were among those named as parties. None of the other defendants

are parties to this appeal. On August 6, 2012, the court issued an “Order of Dismissal (Case

Settled),” which provides that the matter was “conditionally dismissed without prejudice

until such time [as] a final dismissal entry with prejudice is filed.”

{¶ 3} On October 1, 2012, the Tyes filed a “Motion of Plaintiffs for

Post-Settlement Interest.” The motion provides that the matter was “settled on July 21,

2012 at mediation. * * * After considering whether any of the settlement funds would be put

into a structured settlement, and managing subrogation liens, plaintiffs requested the

settlement checks via an email dated August 24.” The motion further provides that “no

checks have been received. The defendants are now claiming that a Medicare Set-Aside is 3

required as part of the settlement (which was not agreed to at the mediation and is not agreed

to now), but this has no bearing on post-settlement interest, which runs from the settlement

date.”

{¶ 4} On October 16, 2012, defendants other than the Defendants herein filed a

motion requesting the “Court to order Plaintiffs to establish a Medicare Set Aside (MSA)

account out of a portion of the settlement proceeds.” Therein they asserted that they “had

the matter examined by their outside consultant,” and attached to the motion is

correspondence, dated September 20, 2012, from James Pocius, Esq., of Marshall Dennehey

Warner Coleman and Goggin, to Heidi Bevis of Professional Solutions Insurance Co. The

correspondence is addressed to the Tye matter and provides in part as follows: “In the

thousands of workers’ compensation cases where I have supplied Medicare estimates to the

Agency, the Agency has always indicated that an MSA should be done in situations such as

this because the private insurance could be cancelled or lost and then Medicare would be the

primary payer. Therefore, I believe a set aside is necessary in this case.” The

correspondence further provides, “I saw no evidence in this file that anyone checked with

Medicare to determine if conditional payments were made,” and “I am unable to compute a

medical set aside because I do not have any medical records showing claimant’s current

treatment.” Also attached to the motion is correspondence dated July 19, 2012, from John

Cattie, Esq., of the Garretson Resolution Group (“GRG”), to counsel for the Tyes, which

provides in part that “GRG serves as a neutral third party when addressing [Medicare

Secondary Payer] issues, and has been engaged by both plaintiffs and defendants on

thousands of cases directly involving MSP compliance obligations such as conditional 4

payment reimbursement, evaluation of future costs of care (i.e., whether an MSA is

appropriate) and Section 111 reporting.” The correspondence provides that “GRG does

not recognize Mr. Tye as an MSA candidate since a permanent burden shift of the

responsibility to pay for future injury-related medical expenses from the tortfeasor to

Medicare is not expected.”

{¶ 5} The motion concludes that “[a]uthority for this court to make such a finding

[regarding the MSA] is found in” Sipler v. Trans Am Trucking, Inc., 881 F.Supp.2d 635 (D.

N.J. 2012), and Finke v. Hunter’s View, D. Minn. No. 07:4267, 2009 WL 6326944 (Aug. 25,

2009), both of which are attached to the motion. Sipler is a personal injury action in which

the court determined that an MSA was not required. The court noted that “no federal law

requires set-aside arrangements in personal injury settlements for future medical expenses”

and further noted the following distinction:

In contrast to the worker’s compensation scheme that “generally

determine[s] recovery on the basis of a rigid formula, often with a statutory

maximum . . . [t]ort cases . . . involve noneconomic damages not available

in workers’ compensation cases, and a victim’s damages are not determined

by an established formula.” * * * Thus, to require personal injury settlements

to specifically apportion future medical expenses would prove burdensome to

the settlement process and, in turn, discourage personal injury settlements.

Sipler, at 638.

Finally, Finke is also a personal injury action in which the court determined that “there is

no reason for the parties to set aside any certain amount for future Medicare claims.” Finke, 5

*3.

{¶ 6} On October 23, 2012, the Tyes opposed the motion, asserting that there “is

no federal statute mandating MSAs for liability cases,” and that the “only support for

defendants’ motion is a letter * * * from a lawyer in Scranton, Pennsylvania, giving an

opinion based on incomplete and incorrect facts, an opinion given to an insurance company

for one of the defendants.” The Tyes’ memorandum provides as follows:

The Scranton lawyer states, “I saw no evidence in this file that anyone

checked with Medicare to determine if conditional payments were made.”

The court should know that we (and Garretson) have “checked” with

Medicare about their lien. To date, Medicare has paid $1,887 toward Mr.

Tye’s medical care over the last several years, and that was for an infected hip

(i.e., not caused by defendants’ negligence). So we are in the federal

administrative process of working out the Medicare lien. Medicare has

offered to accept $1,152 to settle their lien. In any event, money will be set

aside to cover the Medicare lien. This information was discoverable by

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2014 Ohio 2822, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tye-v-upper-valley-med-ctr-ohioctapp-2014.