State v. Peters

• Decision Date: 27 May 2008
• Docket Number: No. 17855.,17855.
• Citation: 287 Conn. 82,946 A.2d 1231
• Court: Connecticut Supreme Court
• Parties: STATE of Connecticut v. James PETERS et al.

946 A.2d 1231

287 Conn. 82

STATE of Connecticut v. James PETERS et al.

No. 17855.

Supreme Court of Connecticut.

Argued November 19, 2007.

Decided May 27, 2008.

Roger Lee Crossland, for the appellants (defendants).

Gary G. Williams, assistant attorney general, with whom, on the brief, were Richard Blumenthal, attorney general, and Robert A. Nagy, assistant attorney general, for the appellee (plaintiff).

ROGERS, C.J., and NORCOTT, KATZ, VERTEFEUILLE and SCHALLER, Js.

ROGERS, C.J.

This appeal arises from a challenge to the amount of a lien for medicaid benefits that was asserted by the plaintiff, the state of Connecticut, against an arbitration award received by an accident victim from a third party tortfeasor. Specifically, we are asked to consider whether the state can choose to collect reimbursement from the medicaid recipient under federal medicaid law instead of pursuing the third party tortfeasor directly, and, if so, whether the amount of reimbursement must be reduced pro rata to compensate the recipient for the attorney's fees and costs he expended in obtaining the recovery in which the state ultimately shares. The defendants¹ appeal from the trial court's granting of the state's motion for summary judgment on its interpleader action.² We affirm the judgment of the trial court.

The following undisputed facts and procedural history are relevant to this appeal. The named defendant, James Peters, was seriously injured in a motorcycle accident in 1997. Having incurred $280,000 in medical bills, Peters received $62,890.72 in medicaid assistance and $7700 in cash assistance from the state department of social services.³ Thereafter, Peters pursued damages from the tortfeasor and ultimately obtained an arbitration award in the amount of $747,500, which was reduced to $526,298.33 after attorney's fees and costs were deducted. The state department of administrative services, which is responsible for the billing and collection of any money due to the state in public assistance cases; see Peters v. Dept. of Social Services, 273 Conn. 434, 439 n. 5, 870 A.2d 448 (2005); then asserted a lien in the amount of $70,590.72 against the arbitration award pursuant to General Statutes §§ 17b-93 and 17b-94 in order to obtain reimbursement of the public assistance funds that it had paid to Peters.⁴ On June 17, 2005, the state brought an interpleader action against the defendants, seeking a determination of rights to the full amount of the lien. The defendants counterclaimed, asserting that the federal medicaid statutes require that the amount of the lien be reduced pro rata by one third to account for the attorney's fees and costs incurred by Peters in pursuing the arbitration award from the tortfeasor.⁵ The parties then filed cross motions for summary judgment. The trial court, Hon. Robert J. Hale, judge trial referee, granted the state's motion for summary judgment on October 17, 2006, and adopted the holding of the trial court, Dunnell, J., in a related proceeding that presented the same issues as this appeal. Peters v. Dept. of Social Services, supra, at 434, 870 A.2d 448. In that proceeding, Peters had challenged the amount of the lien at a hearing before the department of social services, which had ruled that the state could recover the full amount of the lien. Peters then filed an administrative appeal with the Superior Court under the Uniform Administrative Procedure Act (UAPA), General Statutes § 4-166 et seq. In dismissing that appeal, the trial court concluded that the department of social services was entitled to recover the full amount of the lien because neither federal nor state law required the department to pursue third parties directly for reimbursement of medicaid funds, or, alternatively, to accept a lesser reimbursement by a pro rata share of attorney's fees and costs from the recipient's recovery against a third party tortfeasor.⁶ Peters v Dept. of Social Services, supra, at 440, 870 A.2d 448. In Peters, this court reversed the trial court's judgment for lack of subject matter jurisdiction.⁷ Id., at 447-48, 870 A.2d 448. The state then filed the current inter-pleader action, and the defendants thereafter appealed from the summary judgment rendered in favor of the state.

On appeal, the defendants argue that the trial court improperly concluded that federal law does not require the state to pursue third parties directly for the reimbursement of medicaid funds. Alternatively, the defendants argue that the trial court improperly held that, if the state chooses to collect reimbursement from the medicaid recipient instead of pursuing the tortfeasor directly, the state is not obligated to reduce the amount of its reimbursement pro rata to compensate the recipient for his attorney's fees and costs. We disagree.

We undertake our analysis beginning with the applicable standard of review. "Practice Book § 17-49 provides that summary judgment shall be rendered forthwith if the pleadings, affidavits and any other proof submitted show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. In deciding a motion for summary judgment, the trial court must view the evidence in the light most favorable to the nonmoving party. . . . The party moving for summary judgment has the burden of showing the absence of any genuine issue of material fact and that the party is, therefore, entitled to judgment as a matter of law. . . . On appeal, we must determine whether the legal conclusions reached by the trial court are legally and logically correct and whether they find support in the facts set out in the memorandum of decision of the trial court. . . . Our review of the trial court's decision to grant the defendant's motion for summary judgment is plenary." (Internal quotation marks omitted.) Bellemare v. Wachovia Mortgage Corp., 284 Conn. 193, 198-99, 931 A.2d 916 (2007). The defendants' claim challenging the trial court's interpretation of federal and state statutes is also subject to plenary review. "Issues of statutory construction raise questions of law, over which we exercise plenary review. . . . The process of statutory interpretation involves the determination of the meaning of the statutory language as applied to the facts of the case, including the question of whether the language does so apply. . . . When construing a statute, [o]ur fundamental objective is to ascertain and give effect to the apparent intent of the legislature. . . . In other words, we seek to determine, in a reasoned manner, the meaning of the statutory language as applied to the facts of [the] case, including the question of whether the language actually does apply." (Citations omitted; internal quotation marks omitted.) Alvord Investment, LLC v. Zoning Board of Appeals, 282 Conn. 393, 401-402, 920 A.2d 1000 (2007).

Our interpretation of federal and state statutes is guided by the plain meaning rule. See, e.g., Cambodian Buddhist Society of Connecticut, Inc. v. Planning & Zoning Commission, 285 Conn. 381, 400-401, 941 A.2d 868 (2008) ("With respect to the construction and application of federal statutes, principles of comity and consistency require us to follow the plain meaning rule for the interpretation of federal statutes because that is the rule of construction utilized by the United States Court of Appeals for the Second Circuit. . . . If the meaning of the text is not plain, however, we must look to the statute as a whole and construct an interpretation that comports with its primary purpose and does not lead to anomalous or unreasonable results." [Citation omitted; internal quotation marks omitted.]); Alvord Investment, LLC v. Zoning Board of Appeals, supra, 282 Conn. at 402, 920 A.2d 1000 ("In seeking to determine that meaning, General Statutes § 1-2z directs us first to consider the text of the statute itself and its relationship to other statutes. If, after examining such text and considering such relationship, the meaning of such text is plain and unambiguous and does not yield absurd or unworkable results, extra-textual evidence of the meaning of the statute shall not be considered." [Internal quotation marks omitted.]). We conclude that the federal medicaid statutes reasonably cannot be categorized as plain and unambiguous; see, e.g., Ahern v. Thomas, 248 Conn. 708, 720, 733 A.2d 756 (1999);⁸ and, therefore, our determination of whether the statutes require the state to pursue the third party tortfeasor directly for reimbursement, or, alternatively, require the state to compensate the recipient pro rata for attorney's fees and costs, will encompass the text of the relevant medicaid statutes as well as their broader context and purpose.

We therefore begin with the language of the federal statutes that govern the medicaid assistance program.⁹ The federal medicaid statutes place a priority on state reimbursement of medicaid funds and require that participating states have a recovery policy to effectuate such reimbursement. For states that elect to participate in the medicaid program,¹⁰ title 42 of the United States Code, § 1396a (a)(25)(A), mandates that the state's plan for medical assistance must "provide . . . that the [s]tate or local agency administering such plan will take all reasonable measures to ascertain the legal liability of third parties¹¹ . . . to pay for care and services available under the plan. . . ." Moreover, "in any case where such a legal liability is found to exist after medical assistance has been made available on behalf of the individual and where the amount of reimbursement the [s]tate can reasonably expect to recover exceeds the costs of such recovery, the [s]tate or local agency will seek reimbursement for such assistance to the extent of such legal liability. . . ." (Emphasis added.) 42 U.S.C. § 1396a (a)(25)(B). To facilitate reimbursement, participating states also are required to adopt "laws under which, to the extent...