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Paulsell v. State

Court of Appeals of Louisiana, First Circuit

April 24, 2015


Appealed from the Nineteenth Judicial District Court In and for the Parish of East Baton Rouge State of Louisiana. Docket Number 544,152. Honorable William A. Morvant, Judge.

Nelson W. Wagar, III, Sarah Ney, Metairie, LA, Ronnie G. Penton, Bogalusa, LA, Counsel for Plaintiff-Appellant, Juanita Christine Paulsell, as curator for Patricia Jolynn Paulsell-Lathrop.

Weldon John Hill, II, Neal R. Elliott, Jr., Baton Rouge, LA, Counsel for Intervenor-Appellee, State of Louisiana, through the Department of Health and Hospitals/Medicaid Program.

James D. " Buddy" Caldwell, Attorney General, John Elliott Baker, Irving H. Koch, Special Assistants Attorney General, Covington, LA, Counsel for Defendants-Appellees, State of Louisiana, through the Department of Transportation and Development and the Office of Risk Management.



Page 283

[2014 0567 La.App. 1 Cir 2] GUIDRY, J.

Juanita Christine Paulsell, the curatrix of the interdicted plaintiff, Patricia Jolynn Paulsell-Lathrop, comes before this court to appeal a summary judgment holding her personally liable to reimburse the Louisiana Department of Health and Hospitals -- Medicaid Program (DHH) for a portion of the Medicaid funds expended for medical treatment of injuries Patricia sustained in a motorcycle accident that occurred on June 13, 2005.[1]

On October 8, 2013, the DHH filed a motion seeking summary judgment in its favor to hold Ms. Paulsell personally liable pursuant to La. R.S. 46:446(B), for reimbursement of medical assistance payments paid on behalf of Patricia from June 13, 2005 through December 8, 2008, in the amount of $69,131.92. In support of the motion, the DHH attached the affidavit of Jackie Porta, who in her capacity as section chief in charge of the Medicaid Recovery Unit, attested in part that: (1) Patricia has been a Louisiana Medicaid recipient since September 1, 2005; (2) DHH was never served with Patricia's petition for damages relative to the June 13, 2005 accident; (3) DHH was never provided with 30 days notice prior to the December 11, 2008 settlement of Patricia's claims against the Louisiana Department of Transportation and Development (DOTD); (4) the first " notice" the DHH received of Patricia's lawsuit, and settlement of the same, was on April 14, 2011; [2] and (5) Medicaid paid $69,131.92 in medical assistance payments on behalf [2014 0567 La.App. 1 Cir 3] of Patricia relative to the injuries Patricia sustained in the June 13, 2005 accident.[3] Following a hearing, the trial court granted summary judgment in favor of the DHH and against Ms. Paulsell, in a judgment signed January 6, 2014,[4] which Ms. Paulsell devolutively appeals herein.

Page 284

At issue in this appeal is the application of La. R.S. 46:446(B), which at the time of the summary judgment hearing, provided[5]:

B. Any person or his spouse, representative, or dependent who files suit for the recovery of damages or compensation as the result of an injury, illness, or death for which assistance payments of medical expenses in whole or in part have been paid by the Department of Health and Hospitals, for which the department has an obligation to pay therefor, shall at the time suit is filed cause a copy of the petition to be served on the department, in the manner prescribed by Article 1313 of the Louisiana Code of Civil Procedure. Such person filing suit shall be responsible to the department to the extent of the medical payments or assistance received, interest, and attorney fees if he fails to have service made upon the department. Such person shall also be responsible to the department if he compromises his claim without giving the department written notice at least thirty days before the compromise is affected. This written notice shall include the name and date of birth of all injured or ill recipients and the name and address of the party or parties potentially liable for damages or compensation. [Emphasis added.]

At the hearing on the DHH's motion for summary judgment, Ms. Paulsell argued, for the first time, that there was no proof that she knew that any of [2014 0567 La.App. 1 Cir 4] Patricia's medical treatment had been covered by medical assistance payments from Medicaid. Specifically, counsel for Ms. Paulsell presented the following argument in opposition to the DHH's motion for summary judgment:

[T]here is no affidavit or any supporting testimony that shows that my client had any notice that there was any claim made ... by Medicaid in this case for the $69,000 at the time or even during the pendency of this case.
The truth of the matter is when - - on the evening when this terrible accident happened and this child was air vac'd to Charity Hospital in New Orleans from a location in St. Tammany Parish, her mother arrived in due course and gave the people at Charity Hospital her insurance information. In fact, this - - you know, there was evidence at trial, this loss was covered by insurance by Humana.
There's no - - at no time to my [client's] recollection, and we have seen nothing from the State, was there any bill ever sent to her by Medicaid saying, oh, by the way, you know, somehow in this - - in the midst of all this, you know, we paid for $69,000 and some change, you know, of medical benefits to you. Throughout the course of this case, you know, my client was not on notice that there was anything owed to Medicaid at any time

Page 285

through the settlement of this case on December 8th of 2008. The point being that they're claiming, you know, well, you should have, you know, served us with a petition.

We had no idea that the money was owed, and they have not today in support of their motion provided any affidavits or any testimony or any evidence that shows that my client was on notice that Medicaid had paid this. In fact, my client is aware that Humana paid a lot of money to Charity Hospital for the coverage of the medical treatment to her daughter. She is aware of that, and that's a fact. But the State has shown nothing as far as notice to my client,[6] and that's what their statutory rights are based upon.

The trial court found that La. R.S. 46:446 does not contain any provision placing a burden on the DHH to give or prove notice of the receipt of medical assistance payments made by the DHH. Rather, the trial court found that the DHH had to receive La. C.C.P. art. 1313 service of the lawsuit and that any claim could not be settled without notifying the DHH. Therefore, under the plain language of [2014 0567 La.App. 1 Cir 5] the statute and finding no genuine issue of fact, the trial court granted summary judgment in favor of the DHH awarding it reimbursement of the Medicaid payments made. We agree.

Louisiana Revised Statute 46:446(B) simply provides that the DHH must be formally served, at the time suit is filed, with the petition filed relative to injuries for which the DHH paid all or a portion of the medical expenses and that the DHH must be given 30-days written notice prior to the finalization of a settlement of a claim for injuries for which the DHH paid all or a portion of the medical expenses. Thus, under the plain wording of the statute, all the DHH had to prove is: (1) medical assistance payments were made by the DHH for injuries for which a suit for damages was filed and/or for which a claim was compromised; and (2) the DHH did not receive formal service of the petition for the suit and/or the DHH did not receive 30-days written notice prior to compromise of the claim. As it is undisputed that both the conditions required by La. R.S. 46:446(B) were clearly established, we find the trial court properly granted summary judgment in favor of the DHH.[7]

Page 286

[2014 0567 La.App. 1 Cir 6] CONCLUSION

Having found no genuine issue of material fact and that the DHH is clearly entitled to judgment as a matter of law, we affirm. All costs of these proceedings are cast to the appellant, Juanita Christine Paulsell.


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