Opinion ID: 2264277
Heading Depth: 2
Heading Rank: 4

Heading: Is Medicaid a State Income Disability Act?

Text: The defendants urge us to hold that Medicaid is a state income disability act within the meaning of § 9-19-34.1. Although § 9-19-34.1 does not explicitly refer to Medicaid, defendants maintain that we should consider the statute to be remedial in nature and therefore should construe it liberally because doing so is consistent with the Legislature's goal of controlling the cost of medical malpractice insurance premiums. As a result, argue defendants, Esposito's $381,689.26 claim for medical expenses should be reduced by the amount of medical bills that Medicaid paid on the decedent's behalf. Conversely, Esposito asserts that because § 9-19-34.1 abrogates the common law collateral source rule, we should construe it strictly and conclude that Medicaid benefits are not covered by the statute. To support this position, Esposito presses this Court to adopt the rationale of a California case interpreting a similar statute, which held that Medicaid payments are not admissible as collateral source payments. See Brown v. Stewart, 129 Cal.App.3d 331, 341-42, 181 Cal.Rptr. 112 (1982). [7] She further notes that other jurisdictions have strictly construed collateral source statutes that limit a plaintiff's recovery. See, e.g., Jones v. Kramer, 267 Conn. 336, 838 A.2d 170, 177-78 (2004); Allstate Insurance Co. v. Rudnick, 761 So.2d 289, 293 (Fla.2000); Oden v. Chemung County Industrial Development Agency, 87 N.Y.2d 81, 637 N.Y.S.2d 670, 661 N.E.2d 142, 144 (1995). Esposito contends that these cases are consistent with this Court's well-established rule that statutes that abrogate the common law must be strictly construed. See, e.g., Gem Plumbing & Heating Co. v. Rossi, 867 A.2d 796, 803 (R.I.2005); Simeone, 762 A.2d at 445. Despite this backdrop of cases holding that statutes in derogation of the common law should be strictly construed, defendants argue that the Legislature's use of the term remedy in the preamble to P.L. 1986, ch. 350, coupled with the statute's goal of controlling the cost of insurance premiums, makes clear that § 9-19-34.1 is a remedial statute. Thus, defendants urge, a liberal construction is necessary to effectuate the Legislature's intent. [8] It is our view, however, that a statute is not remedial simply because its goal is to improve societal woes. See Ayers-Schaffner v. Solomon, 461 A.2d 396, 399 (R.I.1983). If this were the case, all statutes would be remedial to some degree. In the parlance of statutory construction, a remedial statute is one which affords a remedy, or improves or facilitates remedies already existing for the enforcement or rights of redress of wrongs   . Id. Section 9-19-34.1 does not fit this definition, however, because it narrows the common law collateral source rule by limiting a plaintiff's recovery. Notwithstanding § 9-19-34.1's abrogation of the common law collateral source rule, defendants note that this Court previously has applied liberal construction to a statute in derogation of the common law. In Dias v. Cinquegrana, 727 A.2d 198, 200 (R.I.1999), we interpreted the word accident to include intentional acts because doing so was necessary to effectuate the Legislature's intent. The statute at issue in Dias abrogated the common law by extending potential liability for automobile accidents to a vehicle's owner, even in the absence of a common law agency relationship with the driver. In construing the statute, we explained that it was imperative to determine and effectuate the Legislature's intent and to attribute to the enactment the meaning most consistent with its policies or obvious purposes. Id. at 199-200. Relying on Dias, defendants urge that even though § 9-19-34.1 abrogates the common law collateral source rule, we should construe it liberally because doing so is necessary to effectuate legislative intent. We disagree for several reasons. First, Dias is inapposite to the present case because the statute at issue in that case afforded a remedy to a plaintiff, whereas § 9-19-34.1 potentially limits a plaintiff's recovery. Second, we see no evidence that the Legislature intended to control the cost of medical malpractice insurance premiums by diverting public Medicaid funds to tortfeasors or their insurers. Finally, and most importantly, whether we apply a strict or liberal reading to § 9-19-34.1, we are not persuaded that the Legislature intended the term income disability act to describe this state's Medicaid program. Although it is true that some Medicaid recipients are disabled, we cannot construe Medicaid as an income disability act, because many Medicaid recipients are not disabled, such as those who are aged sixty-five or older. See § 40-8-3 (listing eligibility requirements for Medicaid). Others who are disabled may not qualify for benefits if their incomes or resources exceed a certain amount. Id. Therefore, disability is not the lynchpin to the receipt of Medicaid; having a disability does not guarantee that a person will receive Medicaid, nor is being disabled a necessary condition to receive Medicaid benefits. See id. Moreover, when a person is eligible to receive Medicaid benefits, the DHS does not provide income to the recipients, but instead makes payments directly to the medical care providers. Section 40-8-4(a) (The [DHS] shall furnish medical care benefits to eligible beneficiaries through a direct vendor payment plan.). Therefore, even though some Medicaid recipients may be disabled, these individuals do not receive income under the program. The defendants acknowledge that Medicaid does not provide income to its recipients and that not all recipients are disabled. They contend, however, that Medicaid is an income disability act within the meaning of § 9-19-34.1 because a person must be income disabled to qualify for benefits. In other words, defendants suggest that a lack of financial resources constitutes a form of disability within the meaning of the statute. This Court has held, however, that when a statute fails to define a term, as is the case with § 9-19-34.1, the words of a statute will be given their usual meaning. Carlson, 77 R.I. at 180, 74 A.2d at 855. Applying this principle to the present case, we cannot accept the proposition that the Legislature intended the word income as an adjective to modify the word disability. Whether we construe the collateral source statute liberally or strictly, we ultimately reach the same conclusion. See id. (Even though a statute is held remedial,    the court cannot arbitrarily extend the ordinary meaning of its language). We see no evidence the Legislature intended § 9-19-34.1 to relieve private tortfeasors and their insurers from liability at the taxpayers' expense, and therefore we conclude that the Legislature intended the term income disability act to mean an act that provides income to persons who are disabled. As noted above, Medicaid does not fit this definition. Our holding that Medicaid is not an admissible collateral source payment under § 9-19-34.1 renders it unnecessary for us to address whether the statute is preempted by federal law or is otherwise unconstitutional.