Windfalls no more? Florida case law supports objecting to admission of gross medical bills involving Medicare payments

By: Steven Gendreau, Esq.

Attorneys defending personal injury claims frequently face evidentiary issues where a plaintiff, who is covered under Medicare, attempts to admit into evidence the gross amount of medical expenses rather than what Medicare actually paid. Courts have struggled with this topic since the Supreme Court, in Joerg v. State Farm 151 So. 3d 1226 (Fla. 2014), called into question what is the proper measure of damages when the plaintiff has received public benefits, such as Medicare.

Support from the Fourth District Court of Appeal

A case from the Fourth DCA has once again offered guidance on this issue.  In Gulfstream Park Racing and Casino v. Volin, the Fourth DCA tossed a $787,000 verdict after concluding the trial court erred by allowing Volin to present the gross amount of her medical expenses at trial.

The panel relied on a 2003 Fourth District case (Thyssenkrupp Elevator Corp. v. Lasky) where the Court barred plaintiffs from introducing evidence regarding gross medical expenses when Medicare paid a substantially reduced rate to resolve the entirety of the bills. As the Gulfstream Court explained:

“It has long been established as a fundamental principle of Florida law that the measure of compensatory damages in a tort case is limited to the actual damages sustained by the aggrieved party[.]” Thus, the court continued, “the amount a doctor bills is not an actual damage if the debt is settled for a lesser amount by a source such as Medicare.”

Florida courts have continuously grappled with this issue since Joerg, where the Supreme Court of Florida held defendants may not present evidence of a claimant’s entitlement to future free or low cost benefits, including Medicare and Medicaid, to reduce future medical damages. While Joerg opined that informing a plaintiff is a beneficiary of future government assistance is “highly prejudicial”, it did not address the issue many Florida courts have left to deal with: past medical expenses paid by Medicare.

Support from the Second District Court of Appeal

Recently, the Second DCA also ruled favorably for the defense on this issue. In Dial v. Calusa Palms Master Association, Inc., the panel found the trial court should have granted a motion in limine precluding admission of the plaintiff’s past gross medical expenses. The court relied on a pre-Joerg decision, Cooperative Leasing, Inc. v. Johnson, where it held that when a plaintiff is covered by Medicare, it is reversible error to present to the jury medical bills in excess of what Medicare agreed to pay.

Florida’s highest court to address issue

It appears the Supreme Court will finally have its chance to address the uncertainty remaining after Joerg. In both Gulfstream and Dial, the panel certified the question of Medicare damages to the Florida Supreme Court. In the meantime, defense attorneys have a handful of helpful precedent when dealing with the admissibility of past medical expenses.

Take-Away

Until the Florida Supreme Court offers finality on this issue, a defendant can prevent the plaintiff from obtaining a “windfall” of damages either by pre-trial motions or objections during trial.