California Medi-Cal Beneficiaries Liability for Injury or Illness
Section 14124.71 provides:
"(a) When benefits are provided or will be provided to a Medi-Cal beneficiary under this chapter because of an injury for which another person is liable, or for which a carrier is liable in accordance with the provisions of any policy of insurance . . ., the director of the Department of Health Services shall have a right to recover from such person or carrier the reasonable value of benefits so provided.
The Attorney General or other specified persons may, to enforce such right, institute and prosecute legal proceedings against the third person or carrier who may be liable for the injury in an appropriate court, either in the name of the director or in the name of the injured person . . . .
(b) the director may: (1) Compromise, or settle and release any such claim, or (2) Waive any such claim, in whole or in part . . . .
(c) No action taken in behalf of the director pursuant to this section or any judgment rendered in such action shall be a bar to any action upon the claim or cause of action of the beneficiary or his representative against the third person who may be liable for the injury, or shall operate to deny to the beneficiary the recovery for that portion of any damages not covered hereunder. . . ."
Section 14124.71 "does not employ a subrogation scheme for recoupment of Medi-Cal benefits.
Rather, it gives the department a direct right of action . . . for recovery of monies spent to treat indigent tort victims.
The department's right is akin to that of the Medi-Cal beneficiary's creditor to recover payment for a debt the beneficiary incurred when, having received injuries for which the tortfeasor might be liable, he accepted treatment for which Medi-Cal paid. . . . Although the department's actual recovery of payment for the debt is conditioned on the existence of a fund created from a judgment or settlement, the department's right to recover is independent of the beneficiary's right--not derivative therefrom." (Wright v. Department of Benefit Payments (1979) 90 Cal. App. 3d 446, 452-453 153 Cal. Rptr. 474 rejecting a claim that the Department's rights under section 14124.71 were derivative and holding that, as a result, there was no basis to impute a beneficiary's negligence to the Department.)
Section 14124.71 gives the Director of the Department of Health Services a direct cause of action against a third party who is liable for a Medi-Cal beneficiary's injury or illness, a right that is not derivative or dependent upon any right the beneficiary might have. (Wright v. Department of Benefit Payments, supra, 90 Cal. App. 3d at pp. 452-453.)
The director's right under section 14124.71 is to recover from a responsible third person only "the reasonable value of benefits" provided.
On the other hand, the statutory assignment created by subdivision (a) of section 14008.6 gives the director a much greater right--to recover from a responsible third party the full amount of the beneficiary's "rights to medical support and to payments for medical care from a third party that the beneficiary may have in his or her own behalf or in behalf of any other family member for whom the beneficiary has the legal authority to assign such rights . . . ."