Friday, December 6, 2013

The Collateral Source Doctrine Does Not Apply to Medical Bills in Excess of Payments Made by Medicare and Medicaid

Judge Cordero of the Superior Court of the District of Columbia, in Jadine Acker v. Specialty Hospital of Washington-Hadley, LLC, No. 2018, granted Defendant Specialty Hospital of Washington-Hadley, LLC.’s Motion In Limine.  The Defendant’s Motion in Limine successfully sought to exclude evidence of medical bills not covered by Medicare and/or Medicaid payments. 

The Plaintiff, Jadine Acker, a Medicare and Medicaid recipient, allegedly fractured her hip when she fell from her hospital bed while in the care of Defendant.  Following this incident, Plaintiff sued for medical malpractice.  Medicare and Medicaid paid for $191,734.39 of the total $581,662.09 in resulting medical bills.

The Defendant argued that the amount of medical bills not paid by Medicare and/or Medicaid were not owed to Plaintiff, and, therefore, evidence of those bills should not be permitted because it would result in the Plaintiff receiving a “windfall.”  The Plaintiff contended that the Defendant’s argument violated the collateral source doctrine.  The collateral source doctrine if applicable would prevent the Defendant from being able to reduce its liability by any amounts received by the Plaintiff from a source collateral to or independent from the Defendant, such as Medicare and/or Medicaid. 

In his July 19, 2013 Order, Judge Codero determined that here “the application of the collateral source rule would . . . result in a double payment by the alleged tortfeasor.”  Judge Codero noted that the reduced payments were made as part of a contractual relationship under which the Defendant was obligated to accept from Medicare and Medicaid set rates for its services and write-off any excess.   

The Court concluded that the collateral source rule did not apply, and, therefore, only evidence of “amounts actually paid by Medicare/Medicaid” were admissible, thus any amounts in excess of the amount paid by Medicare/Medicaid cannot be introduced as evidence at the trial set for April 7, 2014.  

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