Commonwealth v. Wright

276 A.3d 821

COMMONWEALTH of Pennsylvania

v.Colin Lynn WRIGHT, Appellant

No. 486 MDA 2021

Superior Court of Pennsylvania.

Argued March 4, 2022

Filed: May 31, 2022

Jeremy D. Williams, York, for appellant.

Jennilee M. K. Dolan, Assistant District Attorney, York, for Commonwealth, appellee.

James E. Zamkotowicz, Assistant District Attorney, York, for Commonwealth, appellee.

David W. Sunday, District Attorney, York, for Commonwealth, appellee.

BEFORE: OLSON, J., KUNSELMAN, J., and STEVENS, P.J.E.^*

OPINION BY OLSON, J.:

Appellant, Colin Lynn Wright, appeals from the judgment of sentence entered on September 24, 2020. We vacate and remand.

On September 24, 2020, Appellant pleaded guilty to simple assault.¹ In exchange for this plea, the Commonwealth agreed to recommend a sentence of "[two] years [of] probation, plus restitution of $500.00 to [the Pennsylvania Victims Compensation Assistance Program ("VCAP")] in Harrisburg." N.T. Guilty Plea, 9/24/20, at 2. Further, the parties agreed that the Commonwealth "reserve[ed] the ability to modify restitution." Id.

During the plea hearing, Appellant admitted that, on February 20, 2019, he pushed J.M. (hereinafter "the Victim") and that, as a result of this assault, the Victim sustained injuries. Id. at 7; see also Commonwealth's Amended Information, 1/29/20, at 1. On September 24, 2020, the trial court accepted Appellant's plea and, that day, the trial court sentenced Appellant in accordance with the negotiated agreement. N.T. Guilty Plea, 9/24/20, at 12.

On September 25, 2020, the Commonwealth filed its "Motion to Modify Restitution." The motion declared:

Due to the direct cause of the injury [to the Victim, the Victim] had to undergo [shoulder] surgery, various medical procedures, and medical visits. These costs owed by the [Victim] were covered by The [Phia] Group in the amount of $51,039.07. Likewise, [VCAP] has covered $5,974.80 of the [Victim's] medical expenses. Therefore, the Commonwealth is requesting that the total amount of restitution be modified to $57,013.87.

Commonwealth's Motion to Modify Restitution, 9/25/20, at 1 (citations omitted).

The trial court later held a hearing on the Commonwealth's motion. During the restitution hearing, the Commonwealth called Maribel McLaughlin, an employee of The Phia Group, as a witness. As Ms. McLaughlin testified, at the time of the Victim's shoulder surgery, the Victim was employed by HCR ManorCare and she received her health coverage "as an employee through this company." N.T. Restitution Hearing, 12/15/20, at 15-16. HCR ManorCare self-insures its employees’ health care benefits through its self-funded employee benefit plan. Id. The assets of the employee benefit plan are held in trust and the trust is administered by a third-party administrator, Meritain Health. Id. Meritain Health, in turn, "work[s] with Aetna, a network, to obtain preferred providers to cover negotiated fees, and in this case, WellSpan [Health] is a preferred provider through that network." Id. Further, Ms. McLaughlin testified, the Victim received her shoulder surgery at WellSpan Health. See id.

Ms. McLaughlin testified that, in total, "the amount charged to the health plan" for all expenses related to the Victim's shoulder surgery was $63,716.15. Id. at 13-14; see also Commonwealth's Exhibit 2. Ms. McLaughlin testified that "the self-funded benefit plan through HCR ManorCare" then paid a total of $51,039.07 for the Victim's surgical care. N.T. Restitution Hearing, 12/15/20, at 13-14; Commonwealth's Exhibit 2. She testified that the self-funded benefit plan paid the lower amount, as it was "[b]ased on the network [and] ... based on a negotiated amount." N.T. Restitution Hearing, 12/15/20, at 14.

As Ms. McLaughlin testified, The Phia Group "contracted with [the third party administrator, Meritain Health,] to review data and pursue claims for recovery and reimbursement to health plans." N.T. Restitution Hearing, 12/15/20, at 11. She further explained that The Phia Group is "merely the recovery and reimbursement subrogation vendor for HCR ManorCare and Meritain." Id. at 16. She testified: "[The Phia Group does] not pay claims. The claims get paid through the third party administrator, which is Meritain Health. The funds come out of the trust out of HCR ManorCare health plan." Id.

Next, the Commonwealth called Dr. John Deitch as a witness. Dr. Deitch testified that he is an orthopedic surgeon and director of sports medicine for WellSpan Health and that he performed the September 11, 2019 shoulder surgery on the Victim. Id. at 18-19. As Dr. Deitch testified, following the February 20, 2019 assault, the Victim: "[w]as evaluated in the emergency department [on February 20, 2019] and was diagnosed or presented with what appeared to be a shoulder dislocation. It was reduced in the emergency department that night." Id. at 24. As the doctor testified, the medical records reveal that the Victim suffered a "full dislocation" of her shoulder on February 20, 2019. He testified:

[the medical records from February 20, 2019] indicate[ that the Victim] was awaiting post-reduction x-ray. The clinician at the time, based on exam and mechanism per the record, said likely anterior inferior dislocation. The prescribing clinician recommended numbing medicine as well as an antinausea medicine and then performing a shoulder reduction, in other words, put the joint back in place.

Id. at 26-27.

Dr. Deitch testified that he first met with the Victim on June 6, 2019. He testified that he did not immediately recommend surgery "because we needed to get further information to help plan the surgery." Id. at 29. The doctor thus "order[ed an] MRI arthrogram." Id. He testified that, after meeting the Victim in June 2019, the Victim experienced "multiple dislocations or subluxations unrelated to the February incident." Id. The doctor testified that he eventually arrived at the opinion that the Victim required surgery. As he testified: "[the February 20, 2019] dislocation as well as other[ dislocations] precipitated chronic recurrent shoulder instability for which [the Victim] required surgery." Id. at 24 and 25.

The Victim also testified at the restitution hearing. As the Victim testified, before the February 20, 2019 assault, she suffered one prior shoulder dislocation in November 2017. However, she testified: "I had no issues between November of 2017 and February of 2019. Yeah, I had no shoulder problems, nothing. Like, I healed fine. Everything was fine." Id. at 36-37. The Victim testified that, after Appellant assaulted her on February 20, 2019, her shoulder "wouldn't stay stable. Like, I couldn't even reach my arms out to give my kids a hug. My arm would just, like, fall out of [the] socket. Just movement like that, it would just fall out." Id. at 37. She testified that she finally met with Dr. Deitch "because I didn't know what else to do. Like, it wouldn't stay stable. There was nothing I could do. You know, I couldn't function. I couldn't work. I couldn't do anything." Id.

On February 23, 2021, the trial court granted the Commonwealth's motion to modify restitution and ordered Appellant to pay restitution, as part of his direct sentence under 18 Pa.C.S.A. § 1106, in the following amounts: $51,039.07 to The Phia Group and $5,000.00 to VCAP. See N.T. Restitution Hearing, 2/23/21, at 22 and 25. Appellant filed a timely notice of appeal. He raises three issues on appeal:

[1.] Did the trial court err when it modified the sentenc[ing] order when it determined that [The Phia Group] was a victim under 18 Pa.C.S.A. § 1106(c) ?

[2.] Did the trial court err when it modified the sentenc[ing] order by failing to apply the "but for" test to identify damages which occurred as a direct result of the crime and which should not have occurred but for [Appellant's] criminal conduct?

[3.] Did the trial court err when it modified the sentenc[ing] order because the modification was speculative and unsupported by the record?

Appellant's Brief at 4.

Our Supreme Court has explained:

in the criminal context, generally speaking, restitution is the requirement that the criminal offender repay, as a condition of his sentence, the victim or society, in money or services. It is well established that the primary purpose of restitution is rehabilitation of the offender by impressing upon him or her that his [or her] criminal conduct caused the victim's loss or personal injury and that it is his [or her] responsibility to repair the loss or injury as far as possible. Thus, recompense to the victim is only a secondary benefit, as restitution is not an award of damages. Although restitution is penal in nature, it is highly favored in the law and encouraged so that the criminal will understand the egregiousness of his or her conduct, be deterred from repeating the conduct, and be encouraged to live in a responsible way.

Commonwealth v. Brown , 603 Pa. 31, 981 A.2d 893, 895-896 (2009) (footnotes and citations omitted).

In this case, the trial court ordered restitution as a part of Appellant's direct sentence, in accordance with 18 Pa.C.S.A. § 1106. See , e.g. , Trial Court Opinion, 6/3/21, at 19; Commonwealth's Brief at 11. In relevant part, Section 1106(a) reads:

(a) General rule.-- Upon conviction for any crime wherein:

(1) property of a victim has been stolen, converted or otherwise unlawfully obtained, or its value substantially decreased as a direct result of the crime; or

(2) the victim, if an individual, suffered personal injury directly resulting from the crime,

the offender shall be sentenced to make restitution in addition to the punishment prescribed therefor.

...

(c) Mandatory restitution.--

(1) The court shall order full restitution:

(i) Regardless of the current financial resources of the defendant, so as to provide the victim with the fullest compensation for the loss. The court shall not reduce a restitution award by any amount that the victim has received from the Crime Victim's Compensation Board or other government agency but shall

...