Gorman v. Tucker By and Through Edwards

• Decision Date: 06 July 1998
• Docket Number: No. 97SC447,97SC447
• Citation: 961 P.2d 1126
• Parties: 98 CJ C.A.R. 3559 Yolanda GORMAN, Petitioner, v. Janice K. TUCKER, By and Through her legal guardians and next friends, Beverly A. EDWARDS and Dean E. Edwards, Respondents.
• Court: Colorado Supreme Court

Page 1126

961 P.2d 1126

98 CJ C.A.R. 3559

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.

Rodman & Ross-Shannon, John R. Rodman, Raymond J. Lego, Denver, for Petitioner.

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.

We granted certiorari in Tucker v. Gorman, 944 P.2d 653 (Colo.App.1997), to review the court of appeals' decision reversing the trial court's determination that a state department can be reimbursed for expenditures it made under the Colorado Medical Assistance Act (CMAA), see §§ 26-4-101 to -904, 8 C.R.S. (1997), only if the defendant is legally liable to the recipient of Medicaid payments. ¹ In reversing the trial court, the court of appeals held that the comparative negligence statute, see § 13-21-111, 5 C.R.S. (1997), does not bar recovery by the state under the CMAA. We now affirm.

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 Department ³, 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 was 70% negligent and the defendant was 30% negligent. In accordance with its pre-trial ruling, the trial court then entered judgment for the defendant.

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 13-21-111.5(1), 5 C.R.S. (1997), specifically limits the liability of any defendant to an amount not "greater than that represented by the degree or percentage of the negligence or fault attributable to such defendant," and held the defendant liable for 30% of the Department's expenditures.

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 § 2-4-203(1)(a)-(g), 1 C.R.S. (1997). A statute must be read and considered as a whole and should be construed to give consistent, harmonious, and sensible effect to all of its parts. See Brooke v. Restaurant Servs., Inc., 906 P.2d 66, 70 (Colo.1995). With this background in mind, we now address the arguments raised by the parties.

Title XIX of the Social Security Act authorizes federal grants to states to help provide medical assistance to the poor and indigent. See 42 U.S.C. § 1396 (1994); § 26-4-102, 8 C.R.S. (1997). To qualify for these Medicaid funds, a state plan must provide that the administering agency will take reasonable measures to ascertain the legal liability of third parties and to seek reimbursement from such third parties for any medical assistance paid to recipients. See 42 U.S.C. § 1396a(a)(25) (1994).

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 § 26-4-403, 8 C.R.S. (1997). Under this section, the Department may assign its claim to the recipient. See id. Section 26-4-403(3) provides in part:

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 26-4-403(4) provides the Department with an automatic lien for its medical expenditures. See id. Section 26-4-403(4) states:

(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 subsections (3) and (4)(a) of section 26-4-403 and in a regulation ⁴ specifically limits the Department's claim to situations in which a Medicaid recipient is injured by conduct which subjects the tortfeasor to "legal liability." ⁵ The defendant argues that "legal liability" must be determined by reference to the comparative negligence statute. The defendant asserts that she is not legally liable to the Department because Tucker's comparative negligence was 70%. See § 13-21-111, 5 C.R.S. (1997). ⁶ Under the defendant's theory, she would be required to reimburse 100% of the Department's Medicaid expenditures only if she was found to be more than 50% at fault. We reject this argument.

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 § 26-4-403(3), (4). "Imputed" means "attributed vicariously ... not because he is personally ... responsible for it [the imputed action]." See Black's Law Dictionary 682 (5th ed.1979). Applying the comparative negligence statute would result in the recipient's negligence barring the Department's claim and would impute the recipient's negligence to the Department, a state entity that had no negligence in the car accident underlying this case.

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 26-4-403 emphasizes the Department's independent right to recover by stating:

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 26-4-403, the latter provisions must prevail. See § 2-4-205, 1 C.R.S. (1997); M.S. v. People, 812 P.2d 632, 637 (Colo.1991).

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 13-21-203.5, 6A C.R.S. (1994 Supp.) (solatium statute), did not apply unless the defendants were at least 51% liable under the comparative negligence statute. See id. However, the court of appeals also held that once the solatium statute applied, the solatium award was exempt from the reduction mandated by the comparative negligence statute because the solatium statut...