Filling Claim for Medical Expenses for a Child After the Deadline Has Passed
What happens if parents file a claim for medical expenses for their minor child after statute of limitation has run out ?
In Bowmaster v. Clair, 933 A.2d 86 (Pa.Super.2007), the Superior Court reversed an order granting reimbursement to Department of Public Welfare (DPW) in satisfaction of DPW's subrogation lien.
In that case, a minor and her parents commenced a medical malpractice suit alleging that defendants were negligent and the proximate cause of the minor's injuries at birth.
The suit was filed eight years after the minor's birth, beyond the two-year statute of limitations applicable to a parental claim.
DPW paid for the minor's medical expenses through the Medical Assistance (MA) Program and asserted a right to reimbursement under Section 1409(b) when the case was settled.
The issue presented was whether DPW could be reimbursed for medical services provided to the minor when the parents' claim for medical expenses was time-barred.
The Superior Court stated that "a dispute arises as to how provisions found in the Fraud and Abuse Control Act, 62 P.S. 1401 et. seq., are to be applied in such a situation." Id., 933 A.2d at 88 (relying on Hathi v. Krewstown Park Apartments, 385 Pa. Super. 613, 561 A.2d 1261, 1262 (Pa. Super. 1989)).
The Court noted that precedent has established that a minor's injury by negligence leads to two distinct causes of action: one for the minor's parents and one for the minor. Bowmaster, 933 A.2d at 88.
Among the items the parents can recover are medical expenditures made by the parents on the minor's behalf during the child's minority; medical expenses post-majority are recoverable only by the minor. Id.
The Superior Court reasoned that, since the parents are financially responsible for the minor child's medical care, the parents are the true beneficiaries of DPW's payments:
Clearly, parents have an obligation to support their children until the age of majority is reached.
As it was the parents' obligation, medical expenses were paid by DPW to the parents to care for Emily.
Accordingly, the true beneficiary of the benefits received prior to Emily's majority appears to be her parents as it was they who had the support obligation in the first place.
Had the parents received a recovery, we would have agreed that DPW would have been entitled to that amount against the settlement made regardless of how the funds were allotted.
That is not the situation we are presented with here as parents did not seek recovery.
Nothing in the statute allows us to ignore longstanding principles, particularly the principles stated above related to the statute of limitations and what recovery is possible by a minor during his or her period of minority and what recovery could be sought by the minors' parents.
DPW asks us to simply ignore the statute of limitations and the fact that Emily could not recover these medical expenses. Bowmaster, 933 A.2d at 90-91.