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Insurance Lobbyists & Their Attempt To Deprive Injured Victims Of Fair Compensation

On Behalf of | Apr 22, 2015 | Florida Legislative Bill

The Florida Bar News reports that there is a bill moving quickly through the Florida House of Representatives which will allow juries to determine the amount of medical bills awarded as compensatory damages in personal injury suits. HB 1199 by Rep. Larry Metz, R-Groveland, is opposed by both the Florida Justice Association and the Florida Medical Association. Both groups would prefer for the law to stay the same, which has the judge determine the related medical bills, not juries. The bill requires that jurors be told the actual amount paid in medical bills for an injured plaintiff when they determine compensatory damages. In cases where the health-care provider has provided care under a letter of protection (a letter from your attorney assuring payment upon settlement or final judgment), jurors would be told what that doctor or facility would be paid for the care under Medicare or private health insurance company. The bill also would require a doctor or health facility, who has sold the letter of protection to another party, to disclose to the jury the amount that was paid for the letter of protection.

The current law states that the full amount of a medical bill can be entered into evidence, but any award must be reduced to the amount actually paid. The Fourth District Court of Appeal has ruled if the plaintiff did not have health insurance that the full amount of the bill can be entered into evidence. That court reasoned that any lower price actually paid by the plaintiff was earned by the patient in his/her negotiations with the doctor of facility and not a “gratuitous” source.

If passed, the bill would make doctors and health-care facilities less likely to provide care for injured people who are uninsured. If the doctor was providing care with the understanding that he/she would be repaid the full amount of his/her medical bills, but must wait an indefinite period of time to receive reimbursement (sometimes years after the fact), the doctor is usually willing to do endure the financial hardship for the benefit of his/her client. However, if the doctor provided care and would only receive Medicare rates after waiting many years, what is the incentive for the doctor to accept such patients. There are established safeguards in our current system that prevent the injured plaintiff from being overpaid for past medical bills. Judges review and reduce medical compensation awarded by juries and prevent over payment to the injured plaintiff.

Jeff Scott, FMA general counsel, said it is unfair to compare charges in a letter of protection with what a healthcare provider receives from Medicare or from a private health insurance company. Medicare reimbursements, he said, barely covers expenses for providers, while private insurance companies get substantial discounts because they provide a large number of patients.

Tampa attorney Christopher Ligori added that doctors may wait years for payment from a letter of protection, and ultimately not be paid, while insurance companies guarantee quick payments. He said health-care providers have only one set of rates for services, but do offer the discounts for Medicare and private insurance because of the nature and advantages offered by those systems. Ligori also said telling jurors about the amounts doctors receive if they sell letters of protection is unfair, since that is a standard business practice among private companies.

Troy Rafferty, president of the FJA, said defendants now can challenge any medical bill before a judge, something that is routinely done. He also said the bill could leave victims responsible for medical bills from their injuries.

If a health-care provider charges $100,000 for treatments caused by an injury and the jury reduces that to $50,000, “the bill is still $100,000,” Rafferty said. “Now the victim . . . has a judgment against them for $50,000.”

The bill passed by an 8-5 vote. It next goes to the full House Judiciary Committee and if it passes there, to the floor of the lower chamber. A similar measure in the Senate, SB 1240, has been referred to the Judiciary, Banking and Insurance, and Rules committees. e.




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