Agency for Health Care Admin. v. Payas

Full title: Agency for Health Care Administration, Appellant, v. Armando R. Payas…

Court: Florida Court of Appeals, Sixth District

Date published: Oct 6, 2023

No. 6D23-1391 (Fla. Dist. Ct. App. Oct. 6, 2023)

Opinion

6D23-1391

10-06-2023

Agency for Health Care Administration, Appellant, v. Armando R. Payas, Guardian ad Litem for K.T., Ninoshka Rivera, individually and on behalf of K.T., a minor, Appellees.

Alexander R. Boler, Tallahassee, for Appellant. Kara Rockenback Link and David A. Noel, of Link & Rockenback, P.A., West Palm Beach, for Appellee.

WHITE, J.

NOT FINAL UNTIL TIME EXPIRES TO FILE MOTION FOR REHEARING AND DISPOSITION THEREOF IF TIMELY FILED

Appeal from the Circuit Court for Osceola County. Lower Tribunal No. 2011-CA-000197-MP Robert J. Egan, Judge.

Alexander R. Boler, Tallahassee, for Appellant.

Kara Rockenback Link and David A. Noel, of Link & Rockenback, P.A., West Palm Beach, for Appellee.

WHITE, J.

The Agency for Health Care Administration ("AHCA") appeals an order granting the motion to reduce lien filed by Armando R. Payas, Guardian ad Litem for K.T., and Ninoshka Rivera, individually and on behalf of K.T., a minor (hereinafter "K.T."), and denying the motion to dismiss for lack of subject matter jurisdiction filed by AHCA.¹ We have jurisdiction. See Fla. R. App. P. 9.030(b)(1)(A), 9.110. AHCA makes several arguments on appeal, including the argument that the trial court erred because it did not have subject matter jurisdiction over the motion to reduce lien. Because we agree that the trial court lacked subject matter jurisdiction, we do not address AHCA's other arguments. Accordingly, we reverse.

1 This case was transferred from the Fifth District Court of Appeal to this Court on January 1, 2023.

Background

Beginning in 2009, AHCA paid Medicaid benefits for a portion of K.T.'s past medical expenses. K.T. filed a lawsuit in 2011 for alleged medical malpractice. After it was informed of the lawsuit, AHCA asserted a statutory lien for the amount it had paid against any recovery received from third parties. K.T. reached a settlement with the defendants in the medical malpractice case and filed a motion to approve the settlement agreement. The trial court granted that motion in January 2022.

K.T. then filed a motion requesting that the trial court reduce the amount of AHCA's lien. Among other things, K.T. contended that he was entitled to have the trial court determine whether AHCA's lien should be reduced. AHCA filed an objection to the motion to reduce lien and a motion to dismiss for lack of subject matter jurisdiction. Specifically, AHCA asserted that the Division of Administrative Hearings ("DOAH") had exclusive jurisdiction over any challenge to AHCA's lien. After conducting a hearing, the trial court granted the motion to reduce lien and denied the motion to dismiss for lack of subject matter jurisdiction. This timely appeal followed.

Analysis

"Questions of subject matter jurisdiction are reviewed de novo." Nguyen v. Nguyen, 337 So.3d 896, 899 (Fla. 5th DCA 2022) (quoting Stanek-Cousins v. State, 912 So.2d 43, 48 (Fla. 4th DCA 2005)). The parties agree that the trial court had subject matter jurisdiction, if the 2009 version of section 409.910(17) applies. They also agree that it did not, if the 2021 version applies.

AHCA argues that the 2021 version applies because that was the version in effect when the trial court approved K.T.'s settlement agreement. K.T., however, claims that the 2009 version applies because that was when AHCA made the first payment of Medicaid benefits. Therefore, this case turns on which version of section 409.910(17) applies.

AHCA relies on Suarez v. Port Charlotte HMA, LLC, 171 So.3d 740 (Fla. 2d DCA 2015). In that case, Suarez commenced a medical malpractice action, then settled with Dr. Guzman. Id. at 741. After the trial court approved the settlement, Suarez filed a motion contesting AHCA's lien. Id. The trial court determined that it lacked jurisdiction under section 409.910(17)(b) and quashed Suarez's motion. Id.

On review, the Second District observed that a recipient of Medicaid benefits could challenge AHCA's lien in the circuit court before a 2013 amendment of section 409.910(17). Id. at 742. After that amendment, however, any such challenge must made by filing a petition with DOAH. Id. Suarez argued that the 2012 version of the statute applied because she commenced her medical malpractice action before the effective date of the 2013 amendment. Id. The court rejected that argument and declared:

AHCA had no right to reimbursement until a settlement was reached. Section 409.910 states:

If benefits of a liable third party are discovered or become available after medical assistance has been provided by Medicaid, it is the intent of the legislature that Medicaid be repaid in full and prior to any other person, program, or entity. Medicaid is to be repaid in full from, and to the extent of, any third-party benefits.

§ 409.910(1)² (emphasis added). Thus, it is the recovery of third-party benefits that causes AHCA's right to recovery to vest. Because the settlement with Dr. Guzman was not reached until 2014, AHCA had no right to recovery until that time. Accordingly, the 2013 version of the statute controls. See Fla. Ins. Guar. Ass'n v. Bernard, 140 So.3d 1023, 1029 (Fla. 1st DCA 2014) (explaining that "the determinative point in time separating prospective from retroactive application of an enactment is the date the 'cause of action' accrues," which is the date that a party has the right to sue (quoting Prejean v. Dixie Lloyds Ins. Co., 660 So.2d 836, 837 (La. 1995))).

Suarez, 171 So.3d at 742.³ Therefore, the Second District determined that the circuit court lacked jurisdiction to resolve Suarez's challenge to AHCA's lien and denied her petition for writ of mandamus. See id. at 741, 743. We agree with Suarez.

2 This language is the same in the 2009 and 2021 versions of the statute.

3 The First District has applied that holding in Suarez to determine which version of section 409.910 is applicable. See Cabrera v. Agency for Health Care Admin., 315 So.3d 140, 142 (Fla. 1st DCA 2021); Eady v. State, 279 So.3d 1249, 1250 n.1 (Fla. 1st DCA 2019).

K.T. argues that Suarez is inapposite because that court did not address the argument made here: a recipient's right to challenge AHCA's lien accrues on the date that AHCA first paid Medicaid benefits. It is true that the Suarez court did not expressly address that argument. It is implicit from its opinion, however, that Suarez's right to challenge AHCA's lien accrued at the same time AHCA's right to recovery accrued, i.e., the date the settlement was reached. See id. at 742.

More importantly, both versions of the statute provide that a recipient's right to challenge AHCA's lien arises after a settlement is obtained. See § 409.910(17), Fla. Stat. (2009) ("A recipient . . . who receives any third-party benefit or proceeds therefrom . . . is required either to pay the agency, within 60 days after receipt of settlement proceeds, the full amount . . . or to place the full amount . . . in a trust account . . . pending judicial or administrative determination of the agency's right thereto."); § 409.910(17)(a), Fla. Stat. (2021) ("A recipient . . . who receives any third-party benefit or proceeds . . . must, within 60 days after receipt of settlement proceeds, pay the agency the full amount . . . or place the full amount . . . in an interest-bearing trust account . . . pending an administrative determination of the agency's right to the benefits under this subsection."). K.T. fails to cite any authority stating that a recipient's right to challenge AHCA's lien or AHCA's right to recovery against a settlement accrues before a settlement is reached.

K.T. contends that this case is governed by the Florida Supreme Court's holding that "a cause of action under the Act accrues when the State makes a Medicaid payment to a recipient." Agency for Health Care Admin. v. Associated Indus. of Fla., Inc., 678 So.2d 1239, 1256 (Fla. 1996). K.T.'s reliance on that case is misplaced because the very next sentence makes clear that the Court's holding applied to the "new cause of action" created in 1994. Id. The Court was referring to the agency's independent cause of action against a third party established by the 1994 amendments to section 409.910. See id. at 1244-46, 1248-50. The Court's opinion does not address in any way a dispute between AHCA and a benefits recipient. Thus, we reject K.T.'s assertion that Associated Industries controls here.

For all the foregoing reasons, we hold that K.T.'s right to challenge AHCA's lien and AHCA's right to recovery against the settlement accrued in January 2022 when the trial court approved the settlement agreement. See § 744.387(3)(a), Fla. Stat. (2021) (settlement of a minor's claim after an action is commenced is not effective unless approved by the court); Wilson v. Griffiths, 811 So.2d 709, 712 (Fla. 5th DCA 2002). As a result, we hold that the 2021 version of section 409.910(17) applies, and the trial court did not have jurisdiction to address K.T.'s challenge to AHCA's lien.

Conclusion

The trial court erred by entering the order granting K.T.'s motion to reduce lien and denying AHCA's motion to dismiss for lack of subject matter jurisdiction. We reverse and remand for the trial court to vacate that order and enter an order dismissing K.T.'s motion to reduce lien for lack of subject matter jurisdiction.

REVERSED and REMANDED.

SMITH and MIZE, JJ., concur