Martinez v. Dept. of Health Services, DCA2/6, 1/12/18
This case is interesting because it explains what amount of a Medi-Cal lien should be paid from a personal injury settlement. Here, Medi-Cal advanced about $89k for medical expenses that Martinez incurred for injuries he suffered due to alleged medical negligence. Martinez sued the doctor and settled for $150k. When Martinez and DHS couldn’t agree on how much to pay DHS on its lien, DHS filed a motion to have the court determine the amount. And here’s how that’s done: First, the trial court determined the total value of Martinez’s case by adding $250k in non-economic damages to the $89k in medical costs, for a total value of $366k. The settlement of $150k was 40% of $366k; thus, a maximum of 40% of the Medi-Cal lien ($39k) could be asserted against the settlement. However, the trial court did not reduce the lien by 25% for attorney’s fees, as required by Welfare and Institutions Code 14124.72(d). The appellate court corrected that, further reducing the lien to about $29k. The appellate court affirmed the trial court’s rejection of Martinez’s argument that his case was work over $2MM—MICRA limits non-economic damages to $250k and Martinez had failed to present evidence at trial in support of additional economic damages (e.g., he presented no evidence of lost earning capacity).