Opinion ID: 779713
Heading Depth: 2
Heading Rank: 1

Heading: Whether the recovery cap applies to a suit against the Government

Text: 11 The Plaintiffs argue that we need not reach the question of whether the district court's rationale for refusing to apply the recovery cap is correct, because the Government is not qualified within the meaning of the Medical Malpractice Act and therefore ineligible to benefit from the recovery cap. The Government does not dispute that it has not filed proof of liability insurance and has not paid any surcharge into the Patients' Compensation Fund, and thus, by the terms of section 41-5-5, is not qualified. 12 Three circuits have considered arguments similar to that now offered by the Plaintiffs, and all three circuits have held that the Government was entitled to the recovery cap despite failure to file proof of financial responsibility and to contribute to a compensation fund. See Carter v. United States, 982 F.2d 1141, 1143-44 (7th Cir.1992); Lozada v. United States, 974 F.2d 986, 987 (8th Cir.1992); Owen v. United States, 935 F.2d 734, 737-38 (5th Cir.1991). The rationale supporting these holdings is that (1) the FTCA refers to like circumstances rather than identical circumstances, 3 (2) the financial responsibility of the United States is assured, and (3) its failure to contribute to a compensation fund is immaterial because (unlike qualified providers) it must pay its liabilities without resort to the compensation fund. 4 This court has endorsed these holdings. Hill v. United States, 81 F.3d 118, 121 (10th Cir.1996) (citing, inter alia, Carter, Lozada, and Owen, and stating, These cases stand for the proposition that where there is a specific cap on tort liability, the United States government may benefit from this limit although it did not otherwise participate in the statutory scheme which provides the cap.... 5 13 The Plaintiffs endeavor to distinguish Carter, Lozada, and Owen by arguing that New Mexico law require[s] the United States to attend a Medical Review Panel hearing and grants plaintiffs the benefit of having a physician selected to assist them in continuing to pursue their claims if they are found to have merit. In essence, Haceesa's theory (offered without supporting authority) is that participation in the medical review commission procedures amounts to a qualification for purposes of section 41-5-5, and that New Mexico's qualification procedure thus is materially different from those at issue in Carter, Lozada, and Owen. We disagree. The Medical Malpractice Act establishes two actions that a health care provider shall perform [t]o be qualified: filing proof of insurance and payment of a compensation fund surcharge. N.M. Stat. § 41-5-5. The absence from section 41-5-5 of any requirement of participation in the commission procedures demonstrates the error in the Plaintiffs' argument. In any event, we note the Plaintiffs are mistaken that health care providers are obligated to attend panel hearings. Id. § 41-5-19(A) (providers and their attorneys may attend). 14 The Plaintiffs next argue that private individual[s] under like circumstances, 28 U.S.C. § 2674, generally have not availed themselves of New Mexico's qualification procedures, and thus the Government should not be regarded as having done so. (Aple B. 18 (A review of reported New Mexico cases indicates that most cases brought against negligent hospitals are outside the NMMMA. (citations omitted)).) By contrast, in Carter, the Seventh Circuit noted that [a]ccording to the record, more than 90% of the private medical providers had satisfied analogous qualification procedures. 982 F.2d at 1143. It is not apparent to us why the United States should be precluded from taking advantage of a state liability cap just because a substantial majority of private medical providers voluntarily chose not to qualify as a qualified health care provider. In any event, the record before us is totally inadequate even to establish Plaintiff's factual premise. Accordingly, this argument fails. 15 Finding persuasive the holdings of all of the other circuits to address this issue, we conclude that the Government is not ineligible to invoke the recovery cap merely because it did not satisfy the relevant state qualification procedures. Therefore, we reject Haceesa's proposed alternative grounds for affirmance, and we turn to the grounds actually relied upon by the district court for concluding that the recovery cap did not apply. 16