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Bartee v. Children's Clinic of Southwest Louisiana8/17/2005
Court composed of Sylvia R. Cooks, Michael G. Sullivan, and Glenn B. Gremillion, Judges.
WRIT DENIED.
The issue presented in this writ application is the procedure required of a plaintiff for obtaining reimbursement for medical expenses incurred after the date of judgment in a medical malpractice action. The Patient's Compensation Fund (PCF) contends the procedure for obtaining payment differs among the circuits and the PCF is seeking direction from this court in order to comply with the mandates of the Medical Malpractice Act (MMA). We agreed to hear this writ application to provide guidance to the PCF, and to establish clarity in the Third Circuit on this area of the law.
PROCEDURAL HISTORY
On October 21, 1993, Jamie Bartee suffered severe brain damage when she was seventeen days old. A settlement was reached with the health care provider for the statutory maximum of $100,000.00. Subsequently, the PCF settled for $400,000.00 plus all medical expenses accrued as of May 16, 2004 in the amount of $179,905.77, plus custodial care from the date of the injury through May 16, 2004 at $13.00 an hour in the amount of $275,222.52 for a total of $855,128.20. The PCF also agreed to pay accrued interest in the amount of $144,871.80. A final judgment was rendered on August 14, 2004, in the amount of $1,000,000.00. The judgment specifically reserved plaintiff's right to pursue all future medical and related expenses incurred after May 17, 2004 and continuing, as needed, during her lifetime.
Pamela Bartee, through her attorney, sent requests for reimbursement of medical expenses and custodial care to the PCF on four different occasions: October 27, 2004, November 17, 2004, December 17, 2004, and January 6, 2005. The PCF did not respond. On January 25, 2005, plaintiff filed a Rule to Show Cause in district court seeking to compel the payment of benefits. In response, the PCF filed a Peremptory Exception of Lack of Subject Matter Jurisdiction and Demand for a Jury Trial. The trial court denied the PCF's exception and demand for a jury trial and this writ application followed. Because we find the trial court was correct in denying the PCF's Exception of Lack of Subject Matter Jurisdiction and Demand for a Jury Trial, we deny this writ applicationand rescind the order granting a stay of these proceedings below.
LAW AND DISCUSSION
Position of the PCF
In its brief, the PCF contends the plaintiff has failed to "comply with the administrative appeals requirements [articulated in] Kelty, and as set forth by the PCF Oversight Board in Louisiana Administrative Code, Title 37, ยงยง 1901 et seq., and the Louisiana Administrative Procedures Act, LSA-RS 49:951 et seq. ("APA")." The PCF relies on specific provisions found in Section 44 of the MMA, and language in Kelty v. Brumfield, 93-1142 (La. 2/25/94), 633 So.2d 1210, to support its authority to promulgate administrative regulations which a plaintiff must navigate through when filing a claim for reimbursement of medical expenses incurred after the date of judgment.
La.R.S 40:1299.44 (D)(2)(a) provides:
The board shall be responsible, and have full authority under law, for the management, administration, operation and defense of the fund in accordance with the provisions of this Part. Additionally, the PCF cites La.R.S. 40:1299.44(D)(3), which makes the Administrative Procedure Act (APA) applicable to actions of the Oversight Board. This statute provides:
The board shall have authority, in accordance with applicable provisions of the Administrative Procedure Act, to adopt and promulgate such rules, regulations and standards as it may deem neces
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