Bozeman v. State

879 So.2d 692 (2004)

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Nature of the Case

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Facts

Tommy was catastrophically injured while driving. He suffered brain damage, and numerous fractures, bruises, and abrasions. A helicopter flew him from the accident scene to the LSU Medical Center in Shreveport, where he stayed until June 1993. He remained in long-term care facilities, in a semi-conscious state, until his death on August 29, 1996. On November 2, 1993, he applied for and was granted Medicaid benefits. Ten days later, P filed a Petition for Personal Injuries against the State of Louisiana, Department of Transportation and Development (D). P filed second and third supplemental petitions that added Chrysler Corporation, Jeep-Eagle Corporation, and other related co-defendants. By July 1998, all defendants, except for D, were dismissed. The trial court found D 75% at fault and apportioned 25% of the fault to Tommy. P was awarded damages and $613,626.64 in medical expenses D appealed and asserted that the trial court should have awarded medical expenses against the State of Louisiana for $321,763.08. This figure represents the difference between, $613,626.64, and $291,863.56, the amount of medical expenses paid by Medicaid. The appeals court ordered the trial court to recompute the medical damages. The trial court reduced the medical damages award from $613,626.64 to $344,999.59, and held that the medical expenses 'written off' pursuant to the Medicaid program requirements are not recoverable by P. P appealed, and the Court of Appeal held that P is prevented from recovering those medical expenses that were contractually adjusted or 'written-off' by the healthcare providers pursuant to the Medicaid program. The court's reasoning was based on three main factors: (1) the absence of a natural obligation for the 'write-off' amount, (2) that no windfall should accrue to either the plaintiff or the defendant when the plaintiff is prohibited from recovering the 'write-off' amount, and (3) that federal and state Medicaid statutes dictate that the healthcare providers must accept the payment set by the Medicaid fee schedule as payment in full. The goal of tort recovery is to make the victim whole, and P was made whole by recovering the amounts actually paid by Medicaid, which are the only expenses incurred by the recipient under the program. In Terrell, the Court concluded that no natural obligation existed because there was never any obligation on the part of plaintiffs to satisfy the medical expenses that were written off. The Terrell court referred to four requirements that must be present in order for a duty to be considered a natural obligation. Those requirements are the following: (1) The moral duty must be felt towards a particular person, not all persons in general. (2) The person involved feels so strongly about the moral duty that he truly feels he owes a debt. (3) The duty can be fulfilled through rendering a performance whose object is of pecuniary value. A recognition of the obligation by the obligor must occur, either by performing the obligation or by promising to perform. This recognition brings the natural obligation into existence and makes it a civil obligation. P appealed.