Yolanda GORMAN, Petitioner, v. Janice K. TUCKER, By and Through her legal guardians and next friends, Beverly A. EDWARDS and Dean E. Edwards, Respondents.
No. 97SC447
Supreme Court of Colorado, En Banc.
July 6, 1998.
Rehearing Denied Aug. 10, 1998.
1126
The Law Firm of Michael S. Porter, Michael S. Porter, Wheat Ridge, for Respondents.
Gale A. Norton, Attorney General, Martha Phillips Allbright, Chief Deputy Attorney General, Richard A. Westfall, Solicitor General, Hugo Teufel, Deputy Solicitor General, Andrew P. McCallin, Special Assistant Attorney General, Office of the Attorney General Section, Denver, for Amicus Curiae State of Colorado.
Justice MULLARKEY delivered the Opinion of the Court.
I.
In the early morning hours of October 17, 1992, the recipient, Janice K. Tucker (Tucker), was an inebriated pedestrian who was struck by a car driven by the defendant, Yolanda Gorman. Tucker sustained serious injuries, and as a result, the Colorado Department of Health Care Policy and Financing (Department)2 paid Medicaid benefits on her behalf totaling $69,222.82. Subsequently, Tucker filed two types of claims against the defendant. First, she sued in her personal capacity alleging negligence and negligence per se. Second, as the assignee of the Department3, she sought reimbursement of the Department‘s Medicaid payments. In a pre-trial ruling, the Jefferson County District Court (trial court) held that the Department‘s CMAA claim was recoverable against the defendant only if the defendant was liable to the Medicaid recipient pursuant to the comparative negligence statute.
After Tucker‘s personal claims were dismissed, the case proceeded to trial on the Department‘s CMAA claim, and the jury returned a verdict finding that Tucker personally
The court of appeals reversed and held that the CMAA creates an independent right of action in the Department that cannot be defeated by the negligence of the recipient. However, the court of appeals also determined that section
II.
Before considering the substantive issue raised by the defendant, we will summarize briefly the principles that guide our analysis. Interpretation of a statute is a question of law, and an appellate court is not bound by the trial court‘s interpretation. See Fogg v. Macaluso, 892 P.2d 271, 273 (Colo.1995). In construing statutory provisions, our obligation is to give full effect to the legislative intent. See Colby v. Progressive Cas. Ins. Co., 928 P.2d 1298, 1302 (Colo.1996). If the legislative intent is conveyed by the commonly understood and accepted meaning of the statutory language, we look no further. See id. However, if the statutory language is ambiguous, we look to principles of statutory construction to ascertain legislative intent. See
Title XIX of the Social Security Act authorizes federal grants to states to help provide medical assistance to the poor and indigent. See
As part of this cooperative effort, the CMAA provides the Department with an independent right of action for recovery of medical benefits paid to a recipient for which a third party is liable. See
If medical assistance is furnished to or on behalf of a recipient pursuant to the provisions of this article for which a third party is liable, the state department has an enforceable right against such third party for the amount of such medical assistance. . . . Whenever the recipient has brought or may bring an action in court to determine the liability of the third party, the state department, without any other name, title, or authority to enforce the state department‘s right, may enter into appropriate agreements and assignments of rights with the recipient and the recipient‘s attorney, if any. . . . The contributory negligence of the recipient shall not be imputed to the state department.
(Emphasis added.)
Additionally, section
(a) When the state department has furnished medical assistance to or on behalf of a recipient pursuant to the provisions of this article for which a third party is liable, the state department shall have an automatic statutory lien for all such medical assistance.
. . . .
(e) The state department‘s right to recover under this section is independent of the recipient‘s right. The contributory negligence of the recipient shall not be imputed to the state department.
(Emphasis added.)
The defendant argues that the language relating to third party liability in sub-
Construing the CMAA language relating to third party liability as allowing the comparative negligence statute to bar the Department‘s claim would negate the CMAA‘s non-imputation language. After all, the CMAA explicitly states that the recipient‘s negligence “shall not be imputed to the state department.” See
We can give meaning to all parts of the CMAA by recognizing that the CMAA language relating to third party liability is general in nature and the CMAA‘s more specific non-imputation language controls. The third party liability language does not specifically define when a third party is liable for purposes of the CMAA. Contrary to the defendant‘s interpretation, the clear and explicit language of subsections (3) and (4)(e) in section
The contributory negligence of the recipient shall not be imputed to the state department.
By using this mandatory language, the General Assembly explicitly prohibited the consideration of the recipient‘s liability in the determination of whether a negligent third party is liable to the Department. See People v. Guenther, 740 P.2d 971, 975 (Colo.1987) (stating the word “shall” involves a mandatory connotation and is the antithesis of discretion). To the extent that there is any possible conflict between the general language of third party liability and the specific language concerning the Department‘s independent right to recover its Medicaid expenses in subsections (3) and (4) of section
The defendant cites Dewey v. Hardy, 917 P.2d 305, 310 (Colo.App.1995), for the proposition that the Department cannot recover unless the third party is found liable to the recipient under the comparative negligence statute. In Dewey, the court of appeals held that a solatium award pursuant to section
Moreover, section
Our interpretation is consistent with CMAA subsections (8)9, (9)10, and (10)(c)11 of section
Finally, the defendant contends that courts in other jurisdictions interpreting the
In any case in which the United States is authorized or required by law to furnish hospital, medical, surgical, or dental care and treatment . . . to a person who is injured or suffers a disease, after the effective date of this Act, under circumstances creating a tort liability upon some third person . . . to pay damages therefor, the United States shall have a right to recover from said third person the reasonable value of the care and treatment so furnished or to be furnished and shall, as to this right be subrogated to any right or claim that the injured or diseased person . . . has against such third person. . . .
(Emphasis added.) Specifically, the federal statute lacks any non-imputation language regarding the negligence of the recipient, and, more importantly, explicitly states that the government‘s right is subrogated to the recipient‘s right. We recognize that the General Assembly may have extended Medicaid recovery beyond the requirements of the federal law; however, it is not prevented from doing so when its laws do not contravene federal law.
Because the Department assigned its claim to Tucker, the court of appeals was correct in holding that the comparative negligence statute did not bar the CMAA reimbursement claim. See In re Marriage of Lipira, 621 P.2d 1390, 1391 (Colo.App.1980) (stating assignee takes rights of assignor).
III.
The State of Colorado (State) argues in its brief as amicus curiae that the court of appeals erred in reducing the Department‘s recovery by applying section
We will not consider issues raised only by amicus curiae and not by the parties. See Sherman Agency v. Carey, 195 Colo. 277, 280, 577 P.2d 759, 761 (1978); see also Eugene Cervi & Co. v. Russell, 31 Colo.App. 525, 530, 506 P.2d 748, 751 (1972), aff‘d, 184 Colo. 282, 519 P.2d 1189 (1974). Because this issue was not preserved for our review, we will not address it. See C.A.R. 52; Sherman Agency, 195 Colo. at 280, 577 P.2d at 761 (holding that, even though the party argued the matter before the court, the court would not consider the issue because the issue was not in petition for rehearing in the court of appeals nor in the petition for certiorari).
IV.
In conclusion, we hold that the CMAA creates an independent right of recovery of Medicaid expenditures for the Department which is not defeated by the recipient‘s com-
KOURLIS, J., dissents.
Justice KOURLIS, dissenting:
Because I believe that the CMAA and the comparative negligence statute do not conflict, but rather may be harmonized to give sensible effect to both, I respectfully dissent from the majority‘s holding.
I.
Janice Tucker, bearing 70% of the fault for her injuries, stands to gain roughly $12,000 from a person whom Colorado law does not even recognize as liable in tort.
Under the CMAA, the state has a right to reimbursement for Medicaid expenses where a third party is liable for the injuries caused. See
In this case, the state and Tucker negotiated an assignment of the state‘s Medicaid claim whereby Tucker would receive 60% and the state, 40% of the damages. Tucker then sued Gorman for negligence in her own behalf and also for reimbursement under the Medicaid claim. After dismissal of her personal claims against Gorman, Tucker pursued only the claim based on the Medicaid assignment.
A jury found that Tucker was 70% responsible for the accident, and that Gorman was 30% at fault. The trial court determined that because Gorman was not greater than 50% at fault, as required by the comparative negligence statute, Gorman had no liability under the Medicaid assignment claim. The court of appeals reversed, holding that the comparative negligence statute did not bar the claim. The court of appeals also applied the pro-rata liability statute to reduce Gorman‘s liability to 30% of the $70,000 Medicaid bill ($21,000). Thus, Tucker personally will now receive 60% of that award. Had Tucker not been indigent and received Medicaid benefits, Gorman could not have been held liable, and no damages would have been awarded.
As inequitable as this result appears, the majority‘s holding today opens the door to an even more unjust result whereby a party who is 1% at fault must pay 100% of an indigent person‘s Medicaid bill to cover injuries for which that indigent person is 99% at fault.1 See Colorado State Bd. of Med. Exam‘rs v. Saddoris, 825 P.2d 39, 44 (Colo.1992) (noting that the court should not follow a statutory construction that leads to an absurd result). The majority holds that the language prohibiting the recipient‘s contributory negligence from being imputed to the state specifically overrides the comparative negligence statute. That statute precludes liability unless a party is at least 51% at fault.
I believe that the two statutes can be harmonized such that once legal liability under the comparative negligence statute is triggered, the CMAA allows 100% recovery to the state.
II.
As a matter of statutory construction, section
The CMAA provides that the state has an enforceable right against a third party having liability for a Medicaid recipient‘s injuries. See
The latter part of section
Additionally, we should contemplate the practical effect of our interpretation. Section
The majority concludes that the General Assembly intended to circumvent the existing comparative negligence statute at the time it enacted section
Instead the General Assembly chose to use language that prevents imputation of contributory negligence to the state in cases where a third party has legal liability. Thus, a threshold finding of legal liability is necessary before the non-imputation language becomes effective.
Tucker makes much of the fact that the CMAA creates an independent right of recovery in the state. The significance of this right is that it ensures that the state has standing and is free to pursue reimbursement of its Medicaid expenses where appropriate. However, this “independent right” is not a separate statutory cause of action unrelated to the attribution of fault. Rather, the fact remains that but for the accident, the state would not have incurred medical expenses. The accident was caused by some
In sum, I agree with the trial judge below that we would create
an unjust result, and one certainly not intended by the legislature, to have a defendant who is not legally responsible, or only partially responsible, reimburse all costs to Medicaid. This would make the government able to recover when the recipient of the Medical funds would not be able to recover in an identical lawsuit. That is simply an untenable position. . . .
III.
The General Assembly clearly intended to provide greater recovery to the state in the event it incurs unreimbursed medical expenses on behalf of an accident victim. However, that greater right should not be read to supersede clear principles of tort law that provide recovery only where a defendant is more than equally at fault. I would read tort principles into the CMAA and, accordingly, I would reverse the court of appeals and respectfully dissent.
