Medical assistance payment not a collateral source.

Byline: Barbara L. Jones

The term "pursuant to" decided the outcome of a personal injury case at the Supreme Court and thus, in the words of the dissent, provided a windfall to the injured plaintiff.

The court said that the collateral source statute, Minn. Stat. 548.251, subdivision 1(2), did not encompass discounts negotiated and paid by managed-care organizations under Minnesota's Prepaid Medical Assistance Plan because those are "payments made pursuant to the United States Social Security Act" and therefore are not deducted from the jury's damages award.

The court was divided in the case, Getz v. Peace, with the majority opinion written by Justice Margaret Chutich. Chief Justice Lorie Gildea dissented, joined by Justice Barry Anderson. `

"[T]he only reasonable interpretation of 'payments made pursuant to the United States Social Security Act' is one that includes negotiated discounts by managed-care organizations contracting with Minnesota's Medical Assistance program," Chutich wrote.

Attorney Scott Wilson of Minneapolis, who appealed the case, said that "pursuant to" has a well-settled meaning and the statute was read in accordance with the medical assistance laws. He also noted that approximately 70% to 80% of medical assistance claims are paid through private providers and that about a third of personal injury claims in the state are affected by Medicaid or Medicare. "This case was a long hard fight," he said.

He also said that where there is a collateral source for payment of damages, someone will benefit and the public policy has been that it will be the plaintiff. "It's not a windfall in either direction. It's a policy choice," he said.

There are "islands" in the law where a plaintiff can receive a full recovery, Wilson said. "I don't feel bad about standing on that island with my client."

Defense attorney Daniel Bellig of Mankato, said that the court's broad reading of the term "pursuant to" led the court to allow a windfall under a statute clearly intended to prevent one. He found it "bizarre" to think that the Legislature intended that outcome.

Managed care discounts

The plaintiff was injured when her car struck a school bus that failed to yield at an intersection. The plaintiff was a medical-assistance enrollee, and her medical expenses were covered by two managed-care organizations that contracted with Minnesota's Prepaid Medical Assistance Plan under Minnesota's Medicaid program. She was awarded about $224,998 in past medical...

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