PALMER, J.
The issue that we must resolve in this certified appeal is whether General Statutes § 17b-265 (a),
The opinion of the Appellate Court sets forth the following procedural history and facts, which were stipulated to by the parties and accepted by the trial court. "Under the Medicaid Act (Medicaid); 42 U.S.C. § 1396 et seq. [2012]; federal financial assistance is provided to states that
"The department contracted with [Health Net] directly and through its predecessors from 1995 through 2008 regarding the administration of the Medicaid managed care program. The contract provided that `[t]he [d]epartment hereby assigns to [Health Net] all rights to third party recoveries from Medicare, health insurance, casualty insurance, workers' compensation, tortfeasors, or any other third parties who may be responsible for payment of medical costs for [Health Net's] members.' The contract limited [Health Net's] right to recovery to the amount that [it] paid toward the cost of its member's care. The contract required [Health Net] to make efforts to determine the legal liability of third parties for health care services provided to Medicaid enrollees, and to `pursue, collect, and retain any [money] from [third-party] payers for services to [Health Net's] members under this contract....' The contract further provided that [Health Net] could assign `the right of recovery to [its] subcontractors and/or network providers.'
"[Health Net] contracted with [Rawlings]... to pursue recoveries for medical treatment provided to [Health Net's] members in instances [in which] there was potential for [third-party] liability. When Rawlings became aware that a member was injured by a third party, it typically notified the injured member and the third party that [Health Net] had a right to recover medical expenses paid on the member's behalf.
"Rathbun was a member of [Health Net's] Medicaid managed care plan. [Health Net] paid $2982.93 for medical treatment [rendered in connection with] Rathbun's injuries stemming from a motor vehicle accident that occurred on July 24, 2006. Rathbun retained legal counsel to pursue potential tort claims against the driver of the other vehicle involved in the accident. Rawlings notified Rathbun's counsel, as well as the [driver's] insurer, that [Health Net] had a claim for repayment of the medical benefits it [had] paid on Rathbun's behalf for injuries sustained in the motor vehicle accident. Rathbun's counsel sent a check in the amount of $2982.93 to [Health Net] in satisfaction of [Health Net's] claim.
"Kay' Anah Brayboy, the daughter of Tanequa Brayboy, was a member of [Health Net's] Medicaid managed care plan. On July 4, 2007, Kay' Anah [Brayboy] was struck by a motor vehicle and subsequently died as a result of her injuries. [Health Net] paid $13,541.45 for medical treatment [rendered in connection with] Kay' Anah Brayboy's injuries from the accident. Tanequa Brayboy retained legal counsel to pursue possible tort claims against the driver of the motor vehicle that struck her daughter. Rawlings notified Tanequa Brayboy's counsel that [Health Net] had a claim for repayment for medical benefits paid on behalf of Kay' Anah Brayboy in connection with the motor vehicle accident. [Tanequa] Brayboy subsequently retained new counsel, and Rawlings reissued its notice of claim letter to the attention of [Tanequa] Brayboy's new counsel. To date, [Health Net] has not been reimbursed for the cost of medical care provided to Kay' Anah Brayboy.
"In its memorandum of decision, the [trial] court concluded that the department had assigned its statutory recovery right to [Health Net]. The court noted that under... § 17b-265 (a), the department has the right to be subrogated to any right of recovery that the Medicaid [recipient] may have against a third party. Relying on § 17b-265 (b), which provides that the department may assign its right to subrogation to a designee or health care provider participating in the Medicaid program, the court concluded that the department properly assigned its statutory rights to [Health Net]. The court also concluded that, under Connecticut law, [Health Net], as the assignee of the department, was not required to bring a separate action against [a third-party] tortfeasor to recover the medical expenses expended on behalf of the Medicaid [recipient]. Further, the court found that [Health Net's right to] reimbursement was limited to the amount of Medicaid funds expended by [Health Net] and identified as part of any settlement or judgment." (Footnote altered.) Rathbun v. Health Net of the Northeast, Inc., supra, 133 Conn.App. at 204-207, 35 A.3d 320.
The plaintiffs then appealed to the Appellate Court, claiming that Health Net was prohibited by General Statutes § 52-225c, the antisubrogation statute, from recovering from the plaintiffs the costs of medical care that the plaintiffs had recovered from responsible third parties. Section 52-225c provides in relevant part: "Unless otherwise provided by law, no insurer or any other person providing collateral source benefits as defined in section 52-225b shall be entitled to recover the amount of any such benefits from the defendant or any other person or entity as a result of any claim or action for damages for personal injury or wrongful death regardless of whether such claim or action is resolved by settlement or judgment...." Specifically, the plaintiffs claimed that Health Net's recovery of these amounts was not "otherwise provided by law" within the meaning of § 52-225c because § 17b-265 allowed Health Net to recover only directly from the liable third parties, not from them, and the only other provision that allows a lien to be placed on the proceeds of a legal action brought by a Medicaid recipient, General Statutes § 17b-94 (a),
On appeal to this court, the plaintiffs renew their claim that the right of subrogation created by § 17b-265 (a) and assigned to Health Net pursuant to § 17b-265 (b) does not include the right to seek reimbursement from them for amounts that they had recovered from liable third parties but includes only the right to recover directly from the liable third parties. They contend that allowing Health Net to seek reimbursement from them pursuant to § 17b-265 (a) effectively converts the right to subrogation created by that provision into a lien right, in contravention of the intent of the legislature to confer lien rights exclusively on the state and to limit the amount of the lien to no greater than 50 percent of the amount recovered by the Medicaid recipient from the responsible third party, less the costs of the action, as provided in § 17b-94 (a). We are not persuaded by the plaintiffs' claim.
Our review of the trial court's decision to grant Health Net's motion for summary judgment is plenary. See, e.g., Plato Associates, LLC v. Environmental Compliance Services, Inc., 298 Conn. 852, 862, 9 A.3d 698 (2010). Similarly, whether § 17b-265 authorizes an assignee of the department's statutory subrogation right to seek reimbursement for amounts paid to a Medicaid recipient by a responsible third party is a question of statutory interpretation over which we also exercise plenary review. See, e.g., id. "When construing a statute, [o]ur fundamental objective is to ascertain and give effect to the apparent intent of the legislature.... In other words, we seek to determine, in a reasoned manner, the meaning of the statutory language as applied to the facts of [the] case, including the question of whether the language actually does apply.... In seeking to determine that meaning, General Statutes § 1-2z directs us first to consider the text of the statute itself and its relationship to other statutes. If, after examining such text and considering such relationship, the meaning of such text is plain and unambiguous and does not yield absurd or unworkable results, extratextual evidence of the meaning of the statute shall not be considered.... When a statute is not plain and unambiguous, we also look for interpretive guidance to the legislative history and circumstances surrounding its enactment, to the legislative policy it was designed to implement, and to its relationship to existing legislation and common law principles governing the same general subject matter...." (Footnote omitted; internal quotation marks omitted.) Picco v. Voluntown, 295 Conn. 141, 147, 989 A.2d 593 (2010).
"The state ... has elected to participate in the [M]edicaid program, and, therefore, is obligated to comply with federal requirements. See General Statutes §§ 17b-2 (6) and 17b-260; see also Arkansas Dept. of Health & Human Services v. Ahlborn, 547 U.S. 268, 275-78, 126 S.Ct. 1752,
"The federal statutes illustrate that Congress has mandated that [M]edicaid be a payer of last resort ... and that the state is required to seek reimbursement of [M]edicaid funds. The language of the relevant federal [M]edicaid statutes, however, does not dictate the method that states must employ to effectuate that goal." (Citation omitted; emphasis in original; footnotes omitted; internal quotation marks omitted.) State v. Peters, 287 Conn. 82, 89-93, 946 A.2d 1231 (2008).
With this background in mind, we turn to the text of § 17b-265. The statute provides in relevant part: "In accordance with 42 [U.S.C. §] 1396k, the [d]epartment... shall be subrogated to any right of recovery or indemnification that an applicant or recipient of medical assistance or any legally liable relative of such applicant or recipient has against an insurer or other legally liable third party ... for the cost of all health care items or services furnished to the applicant or recipient, including, but not limited to, hospitalization, pharmaceutical services, physician services, nursing services, behavioral health services, long-term care services and other medical services, not to exceed the amount expended by the department for such care and treatment of the applicant or recipient...." General Statutes § 17b-265 (a). Because the plaintiffs do not dispute that the department has assigned all of its rights under § 17b-265 (a) to Health Net pursuant to § 17b-265 (b), the issue that we must address is the scope of the department's rights under the statute.
The plaintiffs contend that the language of § 17b-265 (a) providing that the department "shall be subrogated to any right of recovery ... that [a] ... recipient of medical assistance ... has against an insurer or other legally liable third party" clearly and unambiguously grants to the department only the right to step into the recipient's shoes and to initiate proceedings against persons other than the recipient. Although we agree with the plaintiffs that the statute clearly and unambiguously confers
We first consider common-law principles governing the doctrine of subrogation. "In its simplest form, subrogation allows a party who has paid a debt to step into the shoes of another (usually the debtee) to assume his or her legal rights against a third party to prevent that party's unjust enrichment.... The commonlaw doctrine of legal or equitable subrogation therefore enables an insurance company that has made a payment to its insured to substitute itself for the insured and to proceed against the responsible third party." (Citation omitted; internal quotation marks omitted.) Fireman's Fund Ins. Co. v. TD Banknorth Ins. Agency, Inc., 309 Conn. 449, 455, 72 A.3d 36 (2013).
"The object of [legal or equitable] subrogation is the prevention of injustice. It is designed to promote and to accomplish justice, and is the mode [that] equity adopts to compel the ultimate payment of a debt by one who, injustice, equity, and good conscience, should pay it.... Subrogation further promotes equity by preventing an insured from receiving more than full indemnification as a result of recovering from both the wrongdoer and the insurer for the same loss, which would unjustly enrich the insured." (Citation omitted; internal quotation marks omitted.) Id., at 456, 72 A.3d 36.
Moreover, "[it] is well established that an insurer's [common-law] right to subrogation ... includes a claim against any judgment secured by the insured against the party at fault for the amount paid by the insurer in satisfaction of the insured's damage claim under the policy." Automobile Ins. Co. v. Conlon, 153 Conn. 415, 419, 216 A.2d 828 (1966); accord Sargeant v. International Union of Operating Engineers, Local Union 478 Health Benefits & Ins. Fund, 746 F.Supp. 241, 245-46 (D.Conn.1990); see also Continental Ins. Co. v. Connecticut Natural Gas Corp., 5 Conn.App. 53, 59, 497 A.2d 54 (1985) ("[t]he principle that an insurer [that] has paid a claim for property destroyed through the fault of a third person may, in certain circumstances, be reimbursed out of the funds received by the insured in satisfaction of his claim against the third person, is generally recognized"); Amica Mutual Ins. Co. v. Barton, 1 Conn.App. 569, 574, 474 A.2d 104 (1984) ("The subrogation right [conferred by General Statutes (Rev. to 1983) § 38-325(c)] does not preclude the insurer from seeking reimbursement from an insured who has pursued his rights and effected a settlement or judgment. To hold otherwise would be to enrich unjustly an insured by allowing him to retain a benefit at the expense of another."); 22 E. Holmes, Appleman on Insurance (2d Ed.2003) § 141.3, p. 433 (if insured recovers insurer's subrogation from liable third party, it must reimburse insurer); 16 L. Russ & T. Segalla, Couch on Insurance (3d Ed.2005) §§ 222:81 and 222:83, pp. 222-120, 222-122 through 222-123 (discussing distinction between insurer's rights to subrogation and reimbursement from insured and noting that some jurisdictions treat them as same right); 16 L. Russ & T. Segalla, supra, § 222:83, p. 222-123 ("if an insurer paid an insured the full amount of his or her claim and the
This conclusion also is supported by the legislative policy underlying § 17b-265. As we have explained, in order to conserve the public fisc, the state Medicaid program is intended to be a payer of last resort. State v. Peters, supra, 287 Conn. at 93, 946 A.2d 1231. To this end, Congress has made it unmistakably clear that, to the extent possible, states should not use Medicaid funds to pay for a recipient's medical services if a third party has been deemed responsible for those costs, and the state must seek reimbursement of amounts for which the third party is liable to the full extent of such liability.
We recognize that Ahlborn and Peters involved state statutes that, unlike § 17b-265, expressly conferred the right to place a lien on amounts recovered by a Medicaid recipient from a liable third party and did not involve statutory right to subrogation. See Arkansas Dept. of Health & Human Services v. Ahlborn, supra, 547 U.S. at 278, 126 S.Ct. 1752 (Arkansas statute, Ark.Code Ann. § 20-77-307[c] [2001], provided that, when Medicaid recipient recovered amounts from liable third party, automatic assignment of recipient's right to recover from third party was considered to be statutory lien on amounts recovered); State v. Peters, supra, 287 Conn. at 92, 96-100, 946 A.2d 1231 (construing § 17b-94). We can perceive no reason, however, why the state can not comply with federal third-party liability requirements by enacting a subrogation statute that incorporates common-law subrogation principles, including the principle that an insurer may seek reimbursement from an insured for costs recovered from a third party for which the insurer already has paid. Indeed, there is no reason to believe that Congress contemplated that there would be any circumstances under which a Medicaid recipient who recovers from a liable third party for the cost of medical services for which the Medicaid program has paid should be entitled to keep that windfall. The plaintiffs in the present case do not dispute that § 17b-265 was intended to meet the state's obligations under federal law. See Maher v. Freedom of Information Commission, 192 Conn. 310, 317-18, 472 A.2d 321 (1984) ("[although] [s]tate participation in the Medicaid program is ... entirely optional... a state must comply with the requirements of [the federal Medicaid statutes] once it elects to participate"). Thus, because the Appellate Court's interpretation was consistent both with common-law principles of subrogation and with federal Medicaid law mandating that participating states recover from liable third parties to the full extent of their liability, we conclude that that court correctly determined that § 17b-265 confers authority on Health Net, as the department's assignee, to seek reimbursement from the plaintiffs for medical costs that the plaintiffs recovered from the liable third parties.
We acknowledge that this interpretation of § 17b-265 tends to render § 17b-94 superfluous as applied to Medicaid recipients, because the state ordinarily will have no reason to seek reimbursement from a Medicaid recipient pursuant to § 17b-94 when the department or its designated assignee can seek full reimbursement of medical costs that a Medicaid recipient recovers from a liable third party pursuant to § 17b-265. As between an interpretation that renders § 17b-94 superfluous as applied to Medicaid recipients and an interpretation that would prevent the state from complying with its obligations under federal law, however, we conclude that the former is more reasonable.
In support of their position, the plaintiffs cite a number of cases that hold that
The plaintiffs also claim that cases standing for the proposition that an insurer may seek reimbursement from its insured for money that the insured has recovered from the wrongdoer are inapposite because they involve equitable subrogation and this case involves the statutory right of subrogation created by § 17b-265. As we have indicated, however, in determining the scope of the right created by § 17b-265, we consider commonlaw principles governing the same general subject matter. We can perceive no reason why the legislature would have intended that the right to subrogation under § 17b-265, unlike the right to subrogation under the common law, would exclude the department's right to reimbursement from Medicaid recipients, thereby providing a windfall to those recipients in violation of federal Medicaid law governing third-party liability in this
The plaintiffs further contend that it is inappropriate to rely on the equitable principles that underlie the doctrine of subrogation to determine the scope of § 17b-265 because nothing in the record supports the conclusion that it would be inequitable to prohibit Health Net from seeking reimbursement from the plaintiffs. Specifically, they claim that "the Appellate Court's equitable findings rest on the wholly unsupported factual assumption that [the] plaintiffs (and all similarly situated Medicaid [recipients]) will obtain a `double recovery' unless they pay Health Net, out of any settlement proceeds recovered from third-party tortfeasors, the full amount that Health Net paid for medical expenses relating to [the plaintiffs'] underling injuries." In addition, the plaintiffs contend that the equities weigh in their favor because "Health Net's business practice is knowingly and deliberately to decline to exercise its statutory subrogation rights against third parties so that it can force [the] plaintiffs to bear its costs of collection... [and] use its insureds as its uncompensated collection agents." (Citations omitted; emphasis in original.)
The factual issue of whether these specific plaintiffs, or other similarly situated plaintiffs, will or will not receive a double recovery if Health Net is barred from seeking reimbursement from them has no bearing on the proper interpretation of § 17b-265, which is the sole issue that is before us in this appeal. The plaintiffs did not claim before the trial court or on appeal to the Appellate Court that, even if § 17b-265 authorizes Health Net to seek reimbursement from Medicaid recipients for medical costs that they recover from liable third parties, Health Net should not be allowed to seek reimbursement from the plaintiffs because they did not recover medical costs from their respective tortfeasors.
Having concluded that the Appellate Court correctly determined that § 17b-265
The judgment of the Appellate Court is affirmed.
In this opinion the other justices concurred.
"(b) An applicant or recipient or legally liable relative, by the act of the applicant's or recipient's receiving medical assistance, shall be deemed to have made a subrogation assignment and an assignment of claim for benefits to the department. The department shall inform an applicant of such assignments at the time of application. Any entitlements from a contractual agreement with an applicant or recipient, legally liable relative or a state or federal program for such medical services, not to exceed the amount expended by the department, shall be so assigned. Such entitlements shall be directly reimbursable to the department by third party payors. The Department of Social Services may assign its right to subrogation or its entitlement to benefits to a designee.... This subsection shall not be construed to affect the right of an applicant or recipient to maintain an independent cause of action against such third party tortfeasor...."
Section 17b-265 has been amended several times since the underlying events in this case occurred. See Public Acts 2012, No. 12-119, § 5; Public Acts 2011, No. 11-61, § 126; Public Acts 2011, No. 11-44, § 84; Public Acts 2010, No. 10-179, § 78; Public Acts 2009, No. 09-8, § 5; Public Acts, Spec. Sess., June, 2007, No. 07-2, § 20. Because the parties do not contend that these amendments are relevant to this appeal, we refer to the current revision of the statute for convenience.
Although § 17b-94 (a) was amended in 2011; Public Acts 2011, No. 11-44, § 71; that amendment has no bearing on the merits of this appeal. We hereinafter refer to the current revision of the statute for convenience.
To be sure, we indicated in State v. Peters, supra, 287 Conn. at 82, 946 A.2d 1231, that § 17b-94 was intended to comply with federal Medicaid law, and, therefore, the meaning of the statute was informed by the relevant federal laws. See id., at 91-95, 946 A.2d 1231 (considering whether federal Medicaid law required state to pursue liable third party directly for purposes of determining whether § 17b-94 embodied that requirement). We now recognize, however, that, because, unlike § 17b-265, § 17b-94 was not intended to embody federal Medicaid law, the scope and meaning of § 17b-94 should not be determined primarily by reference to that law. Nevertheless, to the extent that § 17b-94 applies to Medicaid recipients, any such application must be consistent with federal Medicaid law, that is, its application may be preempted by federal law to the extent that it deprives a Medicaid recipient of a right to which he or she is entitled under federal law. See, e.g., Persico v. Maher, 191 Conn. 384, 393, 465 A.2d 308 (1983) (state law that is inconsistent with federal Medicaid requirements is void); see also Martin ex rel. Hoff v. Rochester, 642 N.W.2d 1, 18 (Minn.2002) (state statute allowing state to place lien on amounts recovered by Medicaid recipient from liable third party for medical costs was preempted by federal Medicaid law to extent that state statute authorized state to recover more from recipient than he or she recovered from liable third party), cert. denied sub nom. Minnesota v. Martin ex rel. Hoff, 539 U.S. 957, 123 S.Ct. 2668, 156 L.Ed.2d 655 (2003). Accordingly, although the court in Peters properly could have considered federal Medicaid law to determine whether the state's application of § 17b-94 to the defendant in that case was consistent with that law, to the extent that the court considered federal Medicaid law to determine the scope and meaning of § 17b-94, it was improvident to do so. We note, however, that our determination in Peters that the state is entitled to seek reimbursement from a Medicaid recipient pursuant to § 17b-94 and that the state is not required to reduce the amount of reimbursement pro rata to compensate the recipient for attorney's fees and costs is fully supported by the plain language of that statute. See State v. Peters, supra, at 97, 946 A.2d 1231.
"So there's no evidence here that these settlements incorporated medical expenses at all. I just don't want that to be assumed somehow that they collected medical expenses. There's no evidence to that effect, and I would argue [that] there would [be] absolutely no legal entitlement for any of these plaintiffs to have claimed medical expenses that were paid by Health Net."
Thereafter, the trial court ordered the parties to submit briefs on the following question: "How, if at all, does the [United States] Supreme [Court's decision] in [Arkansas Dept. of Health & Human Services v. Ahlborn, supra, 547 U.S. 268, 126 S.Ct. 1752] relate to the facts presented here insofar as the portion of any settlements that represent Medicaid expenses are not separately set forth in such settlements?" In Ahlborn, the United States Supreme Court held that the claim of a state agency administering a Medicaid program to the proceeds of a Medicaid recipient's settlement with a liable third party is limited to the amount that the recipient recovered for the costs of medical care. See Arkansas Dept. of Health & Human Services v. Ahlborn, supra, at 284, 126 S.Ct. 1752. In response to the trial court's order, Health Net submitted a brief in which it contended that the plaintiffs had alleged no facts that would support the finding of an Ahlborn violation. The plaintiffs submitted a brief in which they contended that Ahlborn "should not impact the particular issues raised in the plaintiffs' complaint. In particular, the plaintiffs ... are limiting their challenge to the right of private parties to assert the state's § 17b-94 statutory lien rights." The plaintiffs further contended that "[t]he holding in Ahlborn may represent another rationale as to why [Health Net] should not recover its `lien,' but this [issue] is not currently before the court." The plaintiffs did not ask the trial court to address the Ahlborn issue if it concluded that Health Net was entitled to seek reimbursement from them, they did not include any facts relating to this issue in the joint statement of stipulated facts, they did not submit any affidavits or other documents with their brief indicating that they had not recovered medical costs from the respective liable third parties, and they made no such claim in their complaint. The trial court ultimately determined, as a matter of law, that, under Ahlborn, Health Net's right to reimbursement from the plaintiffs was "limited to the amount of Medicaid funds paid and identified as part of any settlement." The court made no factual findings, however, as to whether the amounts that Health Net had recovered from Rathbun and sought to recover from Tanequa Brayboy exceeded the amounts that the plaintiffs had recovered for medical costs. The plaintiffs made no claim in their appeal to the Appellate Court that the trial court improperly failed to make factual findings on this issue or that the case should be remanded to the trial court for resolution of the issue. We therefore reject the plaintiffs' claim that we may and should address this fact bound issue in the present appeal.
We also reject the plaintiffs' argument that, as a matter of law, they could not have recovered medical costs from the liable third parties because they had assigned their rights to such recovery to Health Net. The plaintiffs have cited no authority for the proposition that an insured is categorically prohibited from recovering amounts paid by the insurer from the liable third party. Indeed, the very statute at issue in the present case expressly provides that it "shall not be construed to affect the right of an applicant or recipient to maintain an independent cause of action against [a] third party tortfeasor." General Statutes § 17b-265 (b); see also Arkansas Dept. of Health & Human Services v. Ahlborn, supra, 547 U.S. at 287-88, 126 S.Ct. 1752 (Medicaid recipient who settled claim against tortfeasor did not violate duty to cooperate with state in pursuing liable third party when state agency had intervened in action against tortfeasor and asked to be apprised of proceedings but did not ask to be involved in settlement negotiations); Arkansas Dept. of Health & Human Services v. Ahlborn, supra, at 280 n. 9, 126 S.Ct. 1752 (parties and court assumed "that a [s]tate can fulfill its obligations under the federal third-party liability provisions by requiring an `assignment' of part of, or placing a lien on, the settlement that a Medicaid recipient procures on her own" [emphasis added]); State v. Peters, supra, 287 Conn. at 97 n. 20, 946 A.2d 1231 (existence of assignment to department "is simply a factor to be considered when a recipient determines whether it is economically feasible to pursue a tort recovery" [internal quotation marks omitted]); Shawnee Fire Ins. Co. v. Cosgrove, 86 Kan. 374, 377-78, 121 P. 488 (1912) (insurer has right to enjoin insured from settling case against liable third party for less than amount paid by insurer, but insurer can acquiesce in litigation and settlement subject to insurer's right to reimbursement).
Finally, we emphasize that Health Net has not appealed from the trial court's ruling that it is entitled to reimbursement only for the amounts that the plaintiffs recovered from the liable third parties for medical costs, and nothing in this opinion prevents the plaintiffs or other similarly situated persons from claiming in future proceedings concerning Health Net's reimbursement claims that the amounts sought exceed the amounts that were recovered from the liable third parties for medical costs. Indeed, it is reasonable to conclude that the plaintiffs' attorney was merely attempting to preserve the right to raise this issue in future proceedings when he argued to the trial court that there was no evidence that the plaintiffs had recovered such costs.
There are certain exceptions to the general rule that are not relevant for purposes of this appeal. See 42 U.S.C. § 1396p (a)(1)(A) and (B) (2012).