Peters v. Dept. of Social Services

Citation870 A.2d 448,273 Conn. 434
Decision Date26 April 2005
Docket Number(SC 17311)
PartiesJAMES PETERS v. DEPARTMENT OF SOCIAL SERVICES ET AL.
CourtSupreme Court of Connecticut

Sullivan, C. J., and Borden, Norcott, Katz and Zarella, Js.

Roger Lee Crossland, for the appellant (plaintiff).

Robert A. Nagy, assistant attorney general, with whom, on the brief, was Richard Blumenthal, attorney general, for the appellees (defendants).

Opinion

NORCOTT, J.

The plaintiff, James Peters, appeals from the judgment of the trial court dismissing his administrative appeal from a decision of the named defendant, the department of social services (department), upholding the state's claim for a lien, which was filed by the defendant department of administrative services (administrative services), against an arbitration award granted to the plaintiff. On appeal,1 the plaintiff contends that the trial court improperly concluded that the state was entitled, pursuant to General Statutes §§ 17b-932 and 17b-94,3 to the full amount of its statutory lien for medicaid and public assistance reimbursement from the proceeds of the settlement of a personal injury action without a pro rata reduction for the attorney's fees that had been incurred by the plaintiff in connection therewith. We conclude that although the trial court properly dismissed the plaintiff's administrative appeal, it should have been dismissed on different grounds. We conclude that the trial court lacked subject matter jurisdiction over the plaintiff's administrative appeal pursuant to the Uniform Administrative Procedure Act (UAPA), General Statutes § 4-166 et seq., because the administrative appeal did not relate to a "`[c]ontested case'" as that term is defined by General Statutes § 4-166 (2).4 We, therefore, reverse the judgment and remand the case to the trial court with direction to dismiss the plaintiff's administrative appeal for lack of subject matter jurisdiction.

The record reveals the following facts and procedural history. The plaintiff was seriously injured in a motorcycle accident. Having incurred medical bills in the amount of $280,000, the plaintiff received, from the state, medicaid assistance in the amount of $62,890.72 and general cash assistance in the amount of $7700. The plaintiff thereafter obtained an arbitration award in the amount of $747,500, reduced to $526,298.33 after deducting attorney's fees and costs.

Administrative services subsequently notified the plaintiff that it was placing a lien on the proceeds of his personal injury case for reimbursement of the medicaid assistance and general cash assistance the state had provided, for a total lien amount of $70,590.72.5 Thereafter, the plaintiff's attorney sent a letter to the department's office of legal counsel requesting a hearing to challenge the amount of the lien, and stating his position that the lien should be reduced by one third for "attorneys' fees incurred in the resolution of this matter. . . ."

Subsequently, the department held a hearing, which the notice of decision stated was conducted in accordance with General Statutes §§ 17b-606 and 17b-61,7 as well as the UAPA. The hearing officer rejected the plaintiff's contention that "the amount of the [s]tate's lien for accident related medical assistance [should] be reduced by [a]ttorney's fees and costs pro rata by one third because the [s]tate had the opportunity to sue and it [did not] and saved that cost." The hearing officer also concluded that the amount of the lien as calculated by administrative services was correct. Accordingly, the hearing officer dismissed the plaintiff's claim and ruled that the state could recover from the plaintiff's arbitration award the assistance payments in the total amount of $70,590.72.

The plaintiff then appealed from the department's administrative decision to the trial court. The trial court concluded that, although federal medicaid statutes require that the states have a policy for recovering assistance moneys from third parties, neither federal nor Connecticut law require the state to "pursue third parties on its own." The trial court also determined that neither Connecticut nor federal law provides for pro rata reductions in medicaid lien amounts for "costs incurred in procuring recovery from third parties." Accordingly, the trial court rendered judgment dismissing the plaintiff's appeal. This appeal followed.8

On appeal, the plaintiff, relying primarily on Norwest Bank of North Dakota, N.A. v. Doth, 159 F.3d 328, 334-36 (8th Cir. 1998) (Heaney, J., concurring), and Wilson v. State, 142 Wash. 2d 40, 49-50, 10 P.3d 1061 (2000), cert. denied, 532 U.S. 1020, 121 S. Ct. 1959, 149 L. Ed. 2d 755 (2001), claims that the trial court improperly concluded that the state was entitled to the full statutory lien without a pro rata reduction for his attorney's fees. The department contends otherwise in response, and also claims that both the trial court and this court lack subject matter jurisdiction under the UAPA to hear the plaintiff's appeal because there is no "`[c]ontested case'" under § 4-166 (2) as the hearing was not required by state statute, but rather, pursuant to the settlement in DelVecchio v. Freedman, United States District Court, Docket No. N-86-136 (D. Conn. March 23, 1987).

We begin our analysis with the subject matter jurisdiction claim and the applicable standard of review. "We have long held that because [a] determination regarding a trial court's subject matter jurisdiction is a question of law, our review is plenary." (Internal quotation marks omitted.) Nine State Street, LLC v. Planning & Zoning Commission, 270 Conn. 42, 45, 850 A.2d 1032 (2004). Moreover, "[i]t is a fundamental rule that a court may raise and review the issue of subject matter jurisdiction at any time. . . . Subject matter jurisdiction involves the authority of the court to adjudicate the type of controversy presented by the action before it. . . . [A] court lacks discretion to consider the merits of a case over which it is without jurisdiction . . . ." (Citations omitted; internal quotation marks omitted.) Lewis v. Gaming Policy Board, 224 Conn. 693, 698, 620 A.2d 780 (1993); id., 699 (law of case doctrine did not preclude one trial judge from reexamining previous determination by another trial judge that subject matter jurisdiction existed). The subject matter jurisdiction requirement may not be waived by any party, and also may be raised by a party, or by the court sua sponte, at any stage of the proceedings, including on appeal. Id., 698-99; see also, e.g., Webster Bank v. Zak, 259 Conn. 766, 774, 792 A.2d 66 (2002) ("[t]his court has often stated that the question of subject matter jurisdiction, because it addresses the basic competency of the court, can be raised by any of the parties, or by the court sua sponte, at any time" [internal quotation marks omitted]).9

"There is no absolute right of appeal to the courts from a decision of an administrative agency. . . . The UAPA grants the Superior Court jurisdiction over appeals of agency decisions only in certain limited and well delineated circumstances. . . . Judicial review of an administrative decision is governed by General Statutes § 4-183 (a) of the UAPA, which provides that [a] person who has exhausted all administrative remedies. . . and who is aggrieved by a final decision may appeal to the superior court . . . . A final decision is defined in § 4-166 (3) (A) as the agency determination in a contested case . . . .

"A contested case is defined in § 4-166 (2) as a proceeding. . . in which the legal rights, duties or privileges of a party are required by statute to be determined by an agency after an opportunity for hearing or in which a hearing is in fact held. . . . Not every matter or issue determined by an agency qualifies for contested case status. . . . [W]e have determined that even in a case where a hearing is in fact held, in order to constitute a contested case, a party to that hearing must have enjoyed a statutory right to have his legal rights, duties or privileges determined by that agency holding the hearing . . . . In the instance where no party to a hearing enjoys such a right, the Superior Court is without jurisdiction over any appeal from that agency's determination." (Citations omitted; internal quotation marks omitted.) Lewis v. Gaming Policy Board, supra, 224 Conn. 699-700, quoting New England Dairies, Inc. v. Commissioner of Agriculture, 221 Conn. 422, 427, 604 A.2d 810 (1992).

In Lewis v. Gaming Policy Board, supra, 224 Conn. 694-95, the executive director of the gaming policy board had terminated a state lottery supervisor for insubordination. The supervisor received an initial pretermination hearing before the executive director, and a second hearing before the board, which approved the director's decision to terminate him. Id., 695. The supervisor then appealed from that administrative decision to the trial court pursuant to General Statutes § 4-183 (a) of the UAPA, and the trial court dismissed the administrative appeal. Id., 696.

On appeal, this court stated that, "[e]ven if the plaintiff did have a legal right or privilege in continued employment with the division, and even if that right or privilege was terminated in a deficient proceeding before the executive director and the board, the plaintiff still cannot prevail unless the defendants were statutorily required to determine the plaintiff's legal right or privilege to his continued employment in a hearing." Id., 700-701. This court affirmed the trial court's determination that it lacked subject matter jurisdiction for lack of a "contested case" because the hearing was not statutorily required. Id., 702-703. The court reviewed all of the statutes governing the "activities of the division of special revenue and the gaming policy board"; id., 701; and concluded that, "in the absence of an express statutory requirement obligating the defendants to...

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