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You can search the entire site. or go to the recent opinions, or the chronological or subject indices. Millette v. Millette (10/8/2010) sp-6520

Millette v. Millette (10/8/2010) sp-6520

        Notice:  This opinion is subject to correction before publication in the PACIFIC REPORTER. 
        Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts, 303 
        K   Street,   Anchorage,   Alaska   99501,   phone   (907)   264-0608,   fax   (907)   264-0878,   e-mail 
        corrections@appellate.courts.state.ak.us. 

                 THE SUPREME COURT OF THE STATE OF ALASKA 

MATTHEW J.P. MILLETTE,                          ) 
                                                )       Supreme Court No. S-13315 
                        Appellant,              ) 
                                                )       Superior Court No. 
        v.                                      )       3AN-03-13074 CI 
                                                ) 
CAROL JEAN MILLETTE,                            )       O P I N I O N 
                        Appellee.               ) 
_______________________________   )                    No. 6520 - October 8, 2010 

                Appeal from the Superior Court of the State of Alaska, Third 
                Judicial District, Anchorage, Morgan Christen, Judge. 

                Appearances:       Matthew     J.P.  Millette,  pro   se,  Anchorage, 
                Appellant.   No appearance by Appellee. 

                Before: Carpeneti, Chief Justice, Fabe, and Winfree, Justices. 
                [Eastaugh and Christen, Justices, not participating.] 

                CARPENETI, Chief Justice. 

I.      INTRODUCTION 

                A father appeals a child support judgment from the superior court.                The 

$1,178.75 judgment against him consisted primarily of medical bills incurred on behalf 

of his child.   The medical bills were for natural health care that the child received, and 

that the mother paid for, in order to treat the child's autism.            The father contests the 

judgment   because   it   included   amounts   for   nutritional   supplements   and   associated 

shipping and handling charges, which he claims are not health care expenses as a matter 

of law. Further, the father asserts that the superior court abused its discretion by ordering 

----------------------- Page 2-----------------------

him to pay the bills, some of which he claims to have already paid, and some of which 

were incurred before his child support order became effective.               Finding no error in the 

superior court's order, we affirm the judgment in all respects. 

II.     FACTS AND PROCEEDINGS 

        A.      Past Litigation And Child Custody Arrangements 

                We   first   addressed   the   separation   of   Carol   Jean   Millette   and   Matthew 

                               1 
Millette in January 2008.         The relevant history of their relationship is excerpted here 

from that opinion: 

                        Carol Jean Millette and Matthew Millette were married 
                for    almost   five   years   before    becoming     enmeshed      in   a 
                protracted and contentious divorce and custody dispute.   The 
                couple met online in 1997 through the Christian Connection, 
                an internet dating service. At that time, Carol Jean was living 
                in Colorado and Matthew was living in Alaska, married with 
                two   young   sons.   .   .   .   In   April   1998   Carol   Jean   moved   to 
                Alaska to be with Matthew and lived in an apartment across 
                from his. Matthew divorced his first wife in August 1998 and 
                married   Carol   Jean   a   month   later.   .   .   . The   relationship 
                became rocky after they moved in together . . . . 
                                2 
                        [John]  was born July 21, 2000.         As John grew out of 
                his infancy and became a toddler Carol Jean began to notice 
                [early signs of autism].      In December 2002, when John was 
                almost two and a half years old, he was formally diagnosed 
                with autism.  John has since been seen by many doctors and 
                specialists including . . . Dr. Grove, a naturopathic doctor 
                who   works   with   "Defeat   Autism   Now"   and   who   advises 
                Carol Jean on John's diet . . . . 
                        In June 2003 Carol Jean and Matthew separated. Both 
                Matthew and Carol Jean have since reported misconduct by 

        1 
                Millette v. Millette, 177 P.3d 258 (Alaska 2008). 

        2 
                We use a pseudonym for the child. 

                                                   -2-                                             6520 

----------------------- Page 3-----------------------

                the other parent to the police and the Office of Children's 
                Services (OCS). 
                        Through a domestic violence protective order Matthew 
                obtained     custody    of   John   for  the   first  several   months 
                following      the  parties'   separation.     In    February     2004, 
                following     the   expiration    of  that  order,   Carol   Jean   and 
                Matthew   agreed   to   share   custody   on   a   week-on/week-off 
                basis.      In  July   2004    the   court-ordered     child   custody 
                investigation report recommended that Carol Jean have sole 
                legal and primary physical custody. . . .       In August 2004 the 
                superior court modified interim custody, giving Carol Jean 
                sole legal and physical custody of John. . . . 
                        [The   superior   court]   entered   the   divorce   decree   on 
                October 29, 2004.[3] 

                After a separate custody trial, the court awarded Carol Jean sole legal and 

                                         4 
primary physical custody of John.           Matthew was given visitation rights so long as he 

                                              5 
enrolled in anger management classes.            Additionally, the superior court issued a child 

support order.   That order requires each parent to pay half of John's "reasonable health 

care expenses" up to $5,000 not covered by insurance.  The order states that health care 

expenses "includ[e] medical, dental, vision and mental health counseling expenses." The 

order cites Alaska Rule of Civil Procedure 90.3, which addresses health care expenses 

                                    6 
in an almost identical manner. 

        B.      Expenses Incurred 

                Before and after the court issued the child support order in October 2005, 

Carol Jean incurred and paid health care expenses on behalf of John.                 From March to 

        3 
                Id. at 260-61. 

        4 
                Id. at 261. 

        5 
                Id. 

        6 
                See Alaska R. Civ. P. 90.3(d)(2), (f)(5). 

                                                  -3-                                            6520
 

----------------------- Page 4-----------------------

August 2005, John was treated at Natural Health Center LLC.                  After the order, from 

October 2005 to September 2006, John was treated at the Center for Autism Research 

and Education, LLC (CARE). The bills from these clinics include charges for nutritional 

supplements and their shipping and handling, in addition to charges for appointments. 

The bills from Natural Health Center totaled $698.75, including $340 for appointments, 

$317.75 for supplements, and $41 for shipping. The bills from CARE totaled $1,246.23, 

including $800 for appointments, $437.48 for supplements, and $8.75 for shipping. 

        C.      Proceedings 

                In August 2008 Carol Jean filed a motion in the superior court seeking 

reimbursement from Matthew for half of the above expenses. The superior court ordered 

Matthew to pay half of the expenses ($972.50) and $206.25 in attorney's fees. Matthew 

moved for reconsideration and the superior court denied the motion. 

                Matthew appeals the judgment against him, which totaled $1,178.75. 

III.    STANDARD OF REVIEW 

                We apply de novo review to child support issues involving a question of 

                                         7                                                      8 
law such as interpreting a civil rule,  interpreting the terms of a child support order,  and 

                                                                        9 
determining the correct method for calculating child support. 

                Where no question of law is involved, superior courts have broad discretion 

in making child support determinations, and we review the superior court's decision for 

        7 
                J.L.P. v. V.L.A., 30 P.3d 590, 594 (Alaska 2001). 

        8 
                Rosen   v.   Rosen,   167   P.3d   692,   695   (Alaska   2007)   (citing Flannery   v. 
Flannery, 950 P.2d 126, 129 (Alaska 1997)). 

        9 
                Millette v. Millette, 177 P.3d 258, 261 (Alaska 2008). 

                                                  -4-                                           6520
 

----------------------- Page 5-----------------------

                           10 
an abuse of discretion.       "An abuse of discretion occurs only if based on the record as 

a whole this court is left with a definite and firm conviction that a mistake has been 

         11 
made." 

IV.	    DISCUSSION 

                We address, in turn, the four points Matthew raised on appeal. 

        A.	     The   Superior   Court   Did   Not   Err   In   Concluding   That   Nutritional 
                Supplements Are A Reasonable Health Care Expense. 

                Matthew claims the superior court erred when it ordered him to pay for 

nutritional   supplements,   or   "vitamins,"   for   his   autistic   child. Matthew   asserts   that 

supplements are a component of the child's nutrition, should be covered by the monthly 

child support Matthew pays, and should not require a special judgment for health care 

expenses.      Matthew also makes assertions that arguably go to "reasonableness."                 He 

asserts   that   Carol   Jean   could   have   purchased   less   expensive   supplements   and   that 

supplements are frequently recommended by one's doctor, but are optional. 

                Because we conclude that the nutritional supplements in the present case 

were both a health care expense and reasonable, we affirm the superior court's order 

requiring Matthew to pay half. 

                1.	     Nutritional      supplements      may    be   considered      a  health   care 
                        expense. 

                According to the child support order, Matthew and Carol Jean must each 

                                                                                                     12 
pay half of the child's "reasonable health care expenses not covered by insurance." 

        10 
                Rosen, 167 P.3d at 695. 

        11 
                Id. (internal quotation marks omitted). 

        12 
                The relevant portion of the order states: 

                                                                                       (continued...) 

                                                  -5-                                              6520 

----------------------- Page 6-----------------------

The child support order states health care expenses "includ[e] medical, dental, vision and 

mental health counseling expenses."  Further, the child support order cites to Civil Rule 

                                                                              13 
90.3, which defines health care expenses almost identically.                      Because "health care 

expenses" is not a technical term, we interpret it "according to the rules of grammar and 

                                                                  14 
according   to   [its]   common   and   approved   usage."             We   have   endorsed   a   "broad, 

inclusive"   view   of   what   constitutes   health-related   expenses   for   purposes   of   child 

          15 
support. 

                 Because the child support order and Rule 90.3 both clarify "health care 

expenses"   using   an   enumerated   list   -   medical,   dental,   vision,   and   mental   health 

         12	 
                 (...continued) 
                 Uncovered Health Care Expenses (including medical, dental, 
                 vision and mental health counseling expenses).                Civil Rule 
                 90.3(d)(2) and (f)(5). 
                 The cost of the child(ren)'s reasonable health care expenses 
                 not covered by insurance must be paid as follows, unless the 
                 expenses exceed $5,000 in a calendar year: 
                 :Obligor will pay half and obligee will pay half. 

         13	 
                 The relevant portions of Civil Rule 90.3 provide: 

                 (d)(2):    Uncovered Health Care Expenses. The court shall 
                 allocate equally between the parties the cost of reasonable 
                 health   care   expenses   not   covered   by   insurance   unless   the 
                 court orders otherwise for good cause. 
                 . . . . 
                 (f)(5): Health Care Expenses.   Health care expenses include 
                 medical,      dental,    vision,   and    mental     health    counseling 
                 expenses. 
(Emphasis in original). 

         14 
                 AS 01.10.040(a); see also Tesoro Alaska Petroleum Co. v. Kenai Pipe Line 
Co., 746 P.2d 896, 904 (Alaska 1987). 

         15 
                 Cedergreen v. Cedergreen, 811 P.2d 784, 787-89 (Alaska 1991). 

                                                     -6-	                                              6520
 

----------------------- Page 7-----------------------

counseling - there is a preliminary question of whether that list is exclusive.  It is not. 

We   interpret   enumerated   lists   beginning  with   "including"   or   "includes"   to   be   non- 

                                                                                              16 
exclusive, as if the word were "followed by the phrase 'but not limited to.' "                    Our case 

                                                                            17 
law has extended the same logic to "include" and "included."                    Thus, because the child 

                                                                                                   18 
support order's list begins with "including" and 90.3's list begins with "include,"                   these 

lists   are  illustrative,   not   exclusive.     Accordingly,      we    address    whether    nutritional 

supplements   are   a   health   care   expense,   and   do   not   attempt   to   determine   whether 

supplements are medical, dental, vision, or mental health counseling expenses. 

                 As noted above, we have interpreted health care expenses broadly in the 

                            19                                        20 
child support context.          In  Cedergreen v. Cedergreen,            before Rule 90.3 addressed 

                          21 
health care expenses,         we upheld a superior court's "broad, inclusive" interpretation of 

                                                                 22 
the   contract   term   "medical   and   dental   expenses."          We   ultimately   concluded   that 

counseling,   travel   expenses,   contact   lenses,   and   braces   were   all   medical   and   dental 

         16 
                 AS 01.10.040(b).        "When the words 'includes' or 'including' are used in 
a law, they shall be construed as though followed by the phrase 'but not limited to.' " 
Id. 

         17 
                 Thoeni v. Consumer Elec. Servs., 151 P.3d 1249, 1258 n.41 (Alaska 2007) 
(citing   treatise   on   statutory   interpretation   and   prior   cases   to   demonstrate   that   lists 
beginning with "include," "includes," or "included" are non-exclusive). 

         18 
                 Alaska R. Civ. P. 90.3(f)(5). 

         19 
                 Cedergreen, 811 P.2d at 787-89. 

        20 
                 811 P.2d 784. 

        21 
                 The provisions relevant to this case are 90.3(d)(2) and (f)(5), which were 
added as 90.3(d)(2) and (f)(4) in 1995.             See Alaska Supreme Court Order No. 1192 
(March 10, 1995) (effective July 15, 1995). 

        22 
                 Cedergreen, 811 P.2d at 787. 

                                                    -7-                                               6520
 

----------------------- Page 8-----------------------

           23 
expenses.      However,   we   have   never   addressed   the   precise   question   of   whether 

nutritional supplements qualify as health care expenses for the purposes of child support. 

               To the extent cases from other jurisdictions are relevant, they suggest that 

supplements may be a health care expense if they are subject to professional oversight 

or if they produce demonstrated health benefits.      Addressing a workers' compensation 

claim,    a  Florida  appellate   court  concluded    that  nutritional  supplements    were   a 

reimbursable medical expense when they were taken on the advice of a doctor and 

                                                                                       24 
noticeably beneficial, despite the health care plan's exclusion of "vitamins."             In a 

bankruptcy case from Vermont, the federal  court granted an allowance for vitamins 

where the debtor testified they had "been a sound, prophylactic measure for maintaining 

                       25 
the Debtor's health."      A Mississippi court calculating the custodial parent's expenses 

in order to determine child support made a line item calculation for "medical, dental, 

                        26 
drugs, and vitamins."      And in a divorce decree a Connecticut court took notice of a 

wife's preference for "vitamins and supplements rather than prescribed medication" 

when awarding child support and alimony - although the degree to which the preference 

                                      27 
influenced the award is not stated. 

       23 
               Id. 

       24 
               Tiznado v. Orlando Reg'l Healthcare Sys., 773 So. 2d 584, 586 (Fla. App. 
2000).   The case turned on whether the supplements were "medically necessary," as the 
term is used in the Florida workers' compensation statute.  Id. 

       25 
               In re Edwards, No. 03-10018, 2004 WL 316418, at *8 (Bkrtcy. D. Vt. 
2004). 

       26 
               Creekmore v. Creekmore, 651 So. 2d 513, 519 (Miss. 1995). 

       27 
               Haracsy v. Haracsy, No. FA064005934, 2008 WL 642633, at *2 (Conn. 
Super. Feb. 19, 2008). 

                                              -8-                                         6520
 

----------------------- Page 9-----------------------

                Similarly,   this   case   involves   supplements   purchased   directly   from   the 

clinics treating the autistic child and the charges appear on invoices from the clinics. 

Some   of   the   invoices   for   supplements   also   include   charges   for   appointments.      The 

invoices show the child as a patient.          Those invoices from Natural Health Center list a 

naturopathic doctor, Adam Grove.  The invoices, although not listing a doctor, include 

charges for appointments in addition to supplements.               Carol Jean's affidavit states that 

the charges on the invoices were "medically necessary . . . as a result of [the child's] 

[a]utism."  Accordingly, the present case contains many of the factors relied on by other 

courts to conclude that the cost of supplements is a health care expense. 

                Consistent   with   our   broad   interpretation   of   health   expenses   for   child 

          28 
support,     and other courts' inclusion of nutritional supplements in health care expenses, 

it was not erroneous for the superior court to consider nutritional supplements to be a 

health   care   expense,   particularly   when   the   supplements   are   recommended   by,   and 

purchased from, a health care practice. 

                Matthew's argument that paying for supplements is part of the custodial 

parent's responsibility for nutrition, and so should be paid for from regular child support 

payments, is unpersuasive.         There is no indication that these supplements are needed 

because   the   child   is   not   being   fed   properly. Rather,   the   evidence   shows   that   the 

supplements   were   used   to   treat   a   medical   problem.     The   bills   in   question   show   the 

expenses were incurred at clinics and include items such as evening primrose oil, zinc 

citrate, and methyl B12. In other words, the charges do not appear to be for routine, daily 

multi-vitamins, as one might purchase at the grocery store to supplement nutrition. 

                Matthew's other points about diet and nutrition are similarly unpersuasive. 

First, he defines "supplement" as "something that completes or makes an addition."  He 

        28 
                See Cedergreen v. Cedergreen, 811 P.2d 784, 787-89 (Alaska 1991). 

                                                   -9-                                                6520 

----------------------- Page 10-----------------------

is correct that nutritional supplements generally enhance nutrition, but that does not show 

that they are part of a normal diet that Carol Jean should be providing.  Second, even if 

regular child support is meant to cover everyday nutrition and dietary needs, Matthew 

does not show that regular support is also meant to cover special diets, or that special 

diets are not medical expenses.         Third, he seems to mistake the diet his child eats with 

the nutritional supplements his child takes.  He points out that a medical study found no 

difference in autistic children who avoided gluten and casein, and those who did not. 

That evidence might be relevant were the mother billing the father for grocery items such 

as gluten-free bread, but here there has been no dispute over such food expenses nor any 

                                                                          29 
claims that the child's special diet necessitates supplements.                Indeed, Matthew states 

that   there   is   no   evidence   that   the   "nutritional   supplements   (vitamins)   [are   needed] 

because of this diet." 

                2.       The nutritional supplements were reasonable. 

                Matthew's argument focuses on whether nutritional supplements are health 

care expenses or nutritional expenses, and he does not state that if the expenses are health 

care expenses, they are unreasonable. However, he makes three additional assertions that 

we believe go to reasonableness.             Because health care expenses must be reasonable 

                                                              30 
according to the child support order and Rule 90.3,               we address these assertions. 

                First,    we   are   not   troubled    by   the  fact   that  the   supplements      were 

recommended but not required.            There is no requirement that health care expenses be 

        29 
                Carol     Jean   stated,  in  an   affidavit   filed  with   the  superior    court,  that 
supplements and a special diet are required due to the child's medical condition, but does 
not attribute the need for supplements to the diet. 

        30 
                Alaska R. Civ. P. 90.3(d)(2). 

                                                   -10-                                               6520 

----------------------- Page 11-----------------------

prescribed or required by a doctor in order  to be reimbursable.                   It is sufficient that 

nutritional supplements were professionally recommended for the child's autism. 

                 Second,     Matthew's      argument      that  Carol   Jean   did   not   buy   the  most 

affordable supplements on the market is likewise unpersuasive.                   As the superior court 

noted, because Carol Jean pays half of the health care expenses and lives on a limited 

budget, there are appropriate incentives for her to spend wisely.  Further, that items are 

available less expensively online does not undercut the reasonableness of purchasing 

items directly from a clinic.  Concerns such as convenience, quality, and expediency are 

relevant.   Matthew has not demonstrated per se unreasonableness by showing that items 

are available more cheaply online, particularly without any discussion of whether the 

items are comparable in quality or potency. 

                 Finally, Matthew asserts that the superior court's decision was based on its 

own beliefs, and not representative of the medical evidence presented.  Matthew points 

to a medical study showing that special diets for autistic children are ineffective.                  But, 

as noted above, a special diet is not the same as supplements, so it is not clear that this 

evidence is relevant to Matthew's appeal of nutritional supplement charges. Because the 

nutritional   supplements   were   professionally  recommended,   and   because   there   is   no 

expert testimony suggesting that the health care providers have followed an unreasonable 

course of treatment for the child in this case,  the superior court did not err in declining 

to "second-guess the healthcare decisions made by Ms. Millette." 

                   In   conclusion,   we   affirm   the   superior   court's   decision,   and   hold   that 

nutritional   supplements   may   constitute   a   reasonable   health   care   expense   under   the 

parties' child support order and Civil Rule 90.3(d)(2), particularly where the supplements 

are   taken   for   a   specific   medical   condition,   at   the   recommendation   of   a   health   care 

provider, and purchased through a clinic. 

                                                   -11-                                              6520
 

----------------------- Page 12-----------------------

        B.	      The Superior Court Did Not Err In Including Shipping And Handling 
                 Costs In Health Care Expenses. 

                 Matthew's second point on appeal contests the superior court's treatment 

of shipping and handling costs (totaling less than $50) as health care expenses. Matthew 

cites no authority to support   his claim, and we do not find the claim to be compelling. 

                 Each parent must pay half of the child's health care expenses not covered 

                 31 
by insurance.       The interpretation of "health care expense" is detailed above in section 

                                                                                                    32 
IV.A.    In light of our generally broad interpretation of child support expenses,                      we 

conclude that these shipping and handling charges are likewise appropriately considered 

health care expenses.   The shipping costs represent a small share of the total bills, about 

2.5%. Moreover, shipping costs are not particularly troublesome: Presumably, when one 

buys from a pharmacy, the shipping is inherently a part of the listed price.  It would be 

odd to allow stores to include shipping in their price in this manner, but to disallow it 

when detailed as a separate charge, as was done here.                 And, looking forward, online 

pharmacies are becoming more common, and it is therefore foreseeable that itemized 

shipping and handling will become more common as a part of pharmaceutical expenses 

                    33 
than in the past. 

        31	 
                 Alaska R. Civ. P. 90.3(d)(2), (f)(5). 

        32 
                 See, e.g., Cedergreen, 811 P.2d at 787-88 (approving expenses such as 
airfare, car rental, and hotels). 

        33 
                 Indeed,   the   online   drug   source   Matthew   recommends   Carol   Jean   use, 
because it is cheaper, is a mail order source that also charges shipping.                  See Puritan's 
Pride, Help Center Shipping Policy, http://www.puritan.com/house/helpcenter.asp#ship 
(last visited September 10, 2010). 

                                                   -12-	                                             6520
 

----------------------- Page 13-----------------------

                In conclusion, having determined that the nutritional supplements are a 

reasonable health care expense, we hold that their shipping and handling is a reasonable 

health care expense. 

        C.	     The     Superior     Court    Did    Not   Abuse     Its  Discretion    In   Ordering 
                Matthew To Reimburse Carol Jean $400 For Health Care Expenses 
                Although He Had Already Paid That Amount To The Clinic. 

                Matthew claims that the superior court abused its discretion when it ordered 
him to reimburse Carol Jean $400 for the cost of the child's health care at CARE,34 

because he already paid that amount directly to CARE. 

                We review child support orders for an abuse of discretion, reversing only 

"if based on the record as a whole this court is left with a definite and firm conviction 

                                     35 
that a mistake has been made."           We discern no such abuse of discretion. 

                Matthew and Carol Jean's child support order requires reimbursement to 

the parent who paid the health care expenses: 

                A party shall reimburse the other party for his or her share of 
                the uncovered expenses within 30 days after receiving the 
                health care bill, proof of payment and, if applicable, a health 
                insurance     statement     showing     what    part  of   the  cost   is 
                uncovered. The bill and other materials should be sent within 
                a reasonable time. 

        34      The   full   amount   of   CARE   bills   was  $1,246.23.     Matthew   claims   that 

$446.50 of that sum was for supplements, and therefore appears to be reimbursing his 
half of the remaining amount, roughly $800. 

        35	 
                Rosen v. Rosen, 167 P.3d 692, 695 (Alaska 2007) (internal citation omitted). 

                                                  -13-	                                             6520 

----------------------- Page 14-----------------------

                                                                                                      36 
The child support order makes no provision for directly paying the health care provider. 

Thus,   to   the   extent   Matthew   asserts   that   he   is   required   to   reimburse   only   the   care 

provider, and not Carol Jean, he violates the express terms of the court-ordered child 

support, which requires him to reimburse the parent who paid. 

                Indeed, Matthew's payment to CARE could not even compensate Carol 

Jean for the money she had already expended, as it came after Carol Jean paid the bills 

in full.  And Carol Jean's payment could not be refunded, because, according to a letter 

from CARE, Matthew insisted that his payment was for future services, and should not 

be applied to past treatment.        This leaves Carol Jean without reimbursement for the 

treatment at CARE before October 2006, for which she paid in full. 

                Finally, because the child is no longer treated at CARE, Matthew's $400 

payment to that entity is of no value to Carol Jean. 

                Accordingly, the superior court did not abuse its discretion in ordering 

Matthew   to   reimburse   Carol   Jean   for   one  half   of   her   payments   to   CARE,   despite 

Matthew's $400 payment to the clinic for future treatment. 

        D.	     The     Superior     Court    Did    Not   Abuse     Its  Discretion    In   Ordering 
                Matthew To Pay Old Health Care Bills Incurred Before The Child 
                Support Order Went Into Effect. 

                Matthew claims that he should not be responsible for certain bills because 

they were incurred before the child support order went into effect, and because the bills 

were not timely presented to Matthew. 

        36 
                Similarly, Rule 90.3(d)(2) requires reimbursement to the party who paid. 
The   comment   to   that   rule   allows   prepayment   to   the   provider   when   required   by   the 
provider - but never considers post-payment to the provider, let alone when the other 
party has already paid the bill.      See Alaska R. Civ. P. 90.3 Commentary VII.B. 

                                                  -14-	                                             6520 

----------------------- Page 15-----------------------

                 Because the guidelines of Rule 90.3 govern the apportioning of health care 

expenses when no child support order is in effect, and because the superior court's 

apportioning of expenses was within those guidelines, we conclude that the court did not 

abuse its discretion.   Further, given the circumstances of this case, any alleged delay in 

presenting the bills to Matthew was not unreasonable. 

                 1.	     It   was   not   an   abuse   of   discretion   to   apportion   bills   incurred 
                         before the child support order went into effect. 

                 Matthew's main contention is that it was improper for the superior court to 

order him to pay half of the medical bills from Natural Health Center because those bills 

were incurred before the child support order went into effect.                  The bills from Natural 

Health   Center   were   incurred   between  March   and   August   2005.           Child   support   was 

ordered on October 4, 2005. 

                                                                                                          37 
                 Although a child support order may not apply retroactively to old bills, 

                                                                                    38 
a court may still consider and apportion those old health care bills.                   In that case, the 

court apportions old bills according to the standards of Rule 90.3, not the child support 

       39 
order. 

                 Here, since the child support order was not yet in effect when the five bills 

from Natural Health Center were incurred, Rule 90.3 governs the division of those bills. 

Rule 90.3, like the Millettes' child support order in this case, requires each parent to pay 

        37	 
                Millette v. Millette, 177 P.3d 258, 266 (Alaska 2008). 

        38 
                 See Vachon v. Pugliese, 931 P.2d 371, 381-82 (Alaska 1996) (holding that 
while Rule 90.3 does not expressly apply to payments made before order is in place, 
court may apply Rule 90.3's methodology). 

        39 
                 Id. This treatment does not violate Rule 90.3(h)(2), prohibiting retroactive 
modification, because no order was yet in effect, so there was nothing to modify.  Id. 

                                                   -15-	                                                6520 

----------------------- Page 16-----------------------

                                                         40 
half of the child's reasonable health care expenses.         Accordingly, the superior court's 

judgment requiring Matthew to pay half was consistent with both Rule 90.3 guidelines 

and the child support order, and not an abuse of discretion. 

               2.	     Although   the   bills   may   not   have   been   presented   to   Matthew 
                       immediately, the superior court did not abuse its discretion in 
                       ordering Matthew to pay half. 

               Matthew asserts that he had not received the bills from Natural Health 

Center until Carol Jean filed the motion in superior court, over three years after the bills 

were incurred. 

               As discussed above, Rule 90.3 governs the division of the bills from Natural 

Health Center.     Unlike the Millettes' child support order, that rule does not contain an 

express timeliness provision regarding medical bills. 

               In the present case, faced with conflicting testimony regarding when the 

bills were presented, and a record of ineffective communication between the parties, the 

superior court ordered Matthew to pay half of the bills, regardless of when the bills were 

presented to him.  This is reasonable and fair since the bills were undisputably incurred, 

                                                                                               41 
and we are not left with a definite and firm conviction that a mistake has been made. 

Accordingly, we conclude that the superior court did not abuse its discretion. 

V.	     CONCLUSION 

               Because nutritional supplements can be a reasonable health care expense 

- particularly when purchased from, and recommended by, a clinic treating a medical 

        40 
               Compare Rule 90.3(d)(2) ("The court shall allocate equally between the 
parties the cost of reasonable health care expenses not covered by insurance unless the 
court orders otherwise for good cause.") with the Millettes' child support order ("The 
cost of the child(ren)'s reasonable health care expenses not covered by insurance must 
be paid as follows . . . : Obligor will pay half and obligee will pay half."). 

        41 
               See Rosen v. Rosen, 167 P.3d 692, 695 (Alaska 2007). 

                                               -16-	                                        6520
 

----------------------- Page 17-----------------------

problem - we affirm the superior court's inclusion of supplements, and their shipping 

and handling, in the judgment.            Because the father's payment of certain health care 

expenses to the clinic came after the mother had already paid, and because he did not 

reimburse   her,   we   affirm   the   superior   court's   judgment   against   the   father   for   those 

expenses. Finally, because the father owes half of the child's health care expenses under 

the guidelines set out by Rule 90.3, we conclude that it was not an abuse of discretion for 

the superior court to order the father to pay half of the bills incurred before the child 

support order became effective. Accordingly, we AFFIRM the superior court's judgment 

in all respects. 

                                                   -17-                                              6520
 
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