BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1528
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          SENATE THIRD READING
          SB 1528 (Steinberg)
          As Amended June 27, 2012
          Majority vote 

           SENATE VOTE  :22-13  
           
           JUDICIARY           6-4                                         
           
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          |Ayes:|Feuer, Atkins, Dickinson, |     |                          |
          |     |Monning, Wieckowski,      |     |                          |
          |     |Bonnie Lowenthal          |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Wagner, Gorell, Huber,    |     |                          |
          |     |Jones                     |     |                          |
          |     |                          |     |                          |
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           SUMMARY  :  Seeks to reform compensation, lien and subrogation 
          rights.  Specifically,  this bill  :  

          1)Provides that the county's right of action would continue as a 
            first lien against any judgment, settlement, compromise, 
            arbitration award, mediation settlement, or other recovery for 
            past medical expenses obtained by the injured or diseased 
            person.  The bill would make that lien subject to any liens 
            for attorney's fees and costs incurred by the person or 
            person's representative, estate, or survivors.

          2)Requires specified factors to be considered when a county is 
            requested to compromise or waive any claim, as provided.

          3)Expresses the intent of the Legislature to establish a 
            framework for compensating persons with injuries due to the 
            fault of third parties.

           FISCAL EFFECT  :  None
           
          COMMENTS  :  The author explains that this bill seeks to establish 
          a basis for compensating medical damages while ensuring that the 
          existing statutory framework regarding compensatory damages in 
          medical malpractice cases and actions against public entities is 
          preserved.  The author states:








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               It is a goal of our tort system to ensure that injured 
               people are compensated.  Although plaintiffs have an 
               existing right to sue and the collateral source rule 
               precludes a deduction of compensation to the injured 
               party for amounts paid by the injured party's insurer, 
               a recent California Supreme Court decision, Howell v. 
               Hamilton Meats, Inc., 52 Cal.4th 541 (2011), created 
               uncertainty as to the measure of compensation.  The 
               Howell court held that proof of reasonable value of 
               medical services paid for by the injured party's 
               insurer or rendered by the provider contracting with 
               the insurer is not admissible when measuring the 
               plaintiff's compensatory damages.  

               Howell brought up other issues regarding third party 
               compensation related to plaintiff injury cases, 
               including:  How does Medi-Cal recover costs?  How are 
               providers affected?  How are county governments who 
               provide needed services to their community affected?  
               How are our public Hospitals affected? 

               Because of the variety of stakeholder interests in 
               injury awards, the author has committed to working 
               with all affected stakeholders to find a reasonable 
               solution for all affected parties.  This bill is not 
               intended to impact MICRA �Medical Injury Compensation 
               Reform Act].

          Under existing law, individuals who have suffered injuries 
          caused by tortfeasors may bring an action against the tortfeasor 
          for recovery of damages, including medical costs, to compensate 
          the individual for these injuries.  Existing law, the collateral 
          source rule, provides that when measuring the plaintiff's 
          damages, evidence of the plaintiff's insurance coverage for 
          medical services is inadmissible when used to reduce the amount 
          of compensatory damages.  The collateral source rule reflects 
          the public policy that the tortfeasor should not be allowed to 
          escape liability for the plaintiff's injuries.  

          Recently, in Howell v. Hamilton Meats & Provisions, Inc. (2011) 
          52 Cal.4th 541, the Supreme Court of California created an 
          evidentiary limitation on proving the full value of an injured 
          plaintiff's non-economic damages.  Prior to Howell, courts 








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          allowed juries, in assessing the non-economic damages for pain 
          and suffering, to consider the reasonable value of medical 
          services provided to the injured party because courts recognized 
          that "the cost of medical care often provides both attorneys and 
          juries in tort cases with an important measure for assessing the 
          plaintiff's general damages."  (Helfend v. Southern Cal. Rapid 
          Transit Dist. (1970) 2 Cal.3d; Greer v. Buzgheia (2006) 141 
          Cal.App.4th 1150.)  The Consumer Attorneys of California assert 
          that the Howell decision raises a question of how medical 
          damages are determined.   

          The author argues that because the Howell decision raised policy 
          concerns regarding the just and appropriate measure of damages 
          that an injured plaintiff should be entitled to recover from a 
          tortfeasor, an appropriate framework addressing the measure of 
          damages to be recovered should be established.  The author 
          asserts that, because of the numerous issues raised by the 
          Howell decision, this bill necessitates communication between 
          stakeholders of damages awards, and the author and sponsor have 
          committed to ongoing discussions with stakeholders to establish 
          an appropriate compensatory damages framework that will provide 
          a fair recovery to injured persons and provide an opportunity 
          for state and local governments, as well as health care 
          providers, to obtain fair reimbursement for services from the 
          responsible party.  

          This bill extends the current medical lien rights of counties to 
          settlements in addition to judgments, as under current law, and 
          provides for equitable apportionment of those liens.  Supporters 
          state that current law gives counties lien rights only to 
          judgments, not settlements or other types of compromises.  This 
          limits the ability of counties to be reimbursed when they 
          provide care to injured persons.  This is because courts have 
          strictly interpreted the county lien statute and have not 
          authorized a county lien on a settlement, only on judgments.  
          (Mares v. Baughman (2001) 92 Cal. App. 4th 672, 676-679; Newton 
          v. Clemons (2003) 110 Cal. App. 4th 1, 8-9.)  Because virtually 
          all cases settle and never reach a judgment, counties give up 
          tens of millions of dollars a year in potential lien rights due 
          to this decision.  Furthermore, supporters state, under current 
          law counties are under no obligation to reduce its lien, even if 
          the lien would encompass all or most of a recovery.  The bill 
          further makes these liens subject to attorneys' liens, which 
          currently have priority over all medical liens under existing 








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          law - a point that would be similarly applied to common fund 
          recovery.

          In addition, the bill currently provides an opportunity for 
          equitable apportionment of county liens to remedy some of the 
          harsh effects that supporters claim current lien law can 
          inflict.  Under the bill new equitable considerations are 
          created that may be taken into account when an offer to 
          compromise or waive a lien is presented.  Supporters state that 
          these considerations come from the decades of case law that were 
          the basis of the United States Supreme Court's decision in 
          Arkansas Department of Human Services v. Ahlborn (2006) 547 U.S. 
          268.  These include considerations such as the total value of 
          damages suffered in comparison to the actual amount recovered, 
          whether other liens exist on the recovery, whether the lien is 
          in an amount which would exceed 50% of the ultimate recovery, 
          and any other factors that the court finds to be fair and 
          equitable.  These factors do not increase an injured person's 
          recovery, supporters state, but simply provide the court some 
          equitable factors that can be considered to help injured people 
          receive adequate compensation for their injuries while still 
          protecting the county's right to be reimbursed.  

          The Assembly Judiciary Committee received a number of letters in 
          opposition to this bill reflecting concerns about the 
          supporters' intentions more than the contents of the bill.  For 
          example, the Association of California Insurance Companies 
          (ACIC) states "While ACIC acknowledges that SB 1528 as amended 
          appears to address "lien" recoveries, our overall concern 
          remains that this bill is intended to overturn Howell v. 
          Hamilton Meats Inc., (2011) 52 C.4th 541.  ACIC supports the 
          Howell decision and is fundamentally oppose to any efforts to 
          alter that decision."  A coalition of business groups and others 
          lead by the Civil Justice Association of California states that 
          despite the recent amendments it continues to oppose the bill on 
          the ground that the bill "continues to intend to overturn 
          extensive case law, including but not limited to the recent and 
          well-reasoned California Supreme Court case, Howell v. Hamilton 
          Meats ((2011) 52 Cal.4th 541)."


           Analysis Prepared by  :    Kevin G. Baker / JUD. / (916) 319-2334 










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