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is relevant for a jury to determine what amount is a reasonable charge for the procedure.” Id. The appellate court agreed that the requested information was needed by the defendant “to dispute, as unreasonable, the amount of medical expenses that the plaintiff will seek to recover from them, if the hospital charges non-litigation patients a lower fee for the same medical services.” Id. at 150. Hasson is significant because it illustrates how the reasonableness of medical charges can be determined via an analysis and comparison with what other similarly treated patients were charged and what the medical provider accepted as full payment for non-litigation patients.
In Giacalone v. Hellen Ellis Memorial Hospital, 8 So.3d 1233 (Fla. 2d DCA 2009), an uninsured patient was admitted into the hospital and signed a standard admission form agreeing to pay the account in accordance with the regular rates and terms of the hospital. Following the hospitalization, the patient objected to the bill of approximately $52,000.00 arguing that the charges were unreasonable. The patient sought documents from the hospital regarding the hospital’s charges and discounts granted to various categories of patients (e.g., self-pay patients, Medicare patients, Medicaid patients, charity care patients and privately insured patients) and the hospital’s internal cost structure. The appellate court found that the information sought from the hospital was not only relevant but critical to establish the patient’s defenses and counterclaims, including the unreasonableness of the hospital’s charges. Id.
In Valente v. J.C. Penney Corp., Order, Case No.10-14053-CIV, 2010 WL 11507200 (S.D. Fla. Dec. 16, 2010),
the court held that the non-party physicians’ billing records, fees, discounts and rate comparisons were
“highly relevant to the issue of the plaintiff’s damages.” The requested information was highly relevant to
the issue of the plaintiff’s damages and the healthcare provider’s arguments that the defendant will attempt
to use the records to gain an advantage in the litigation only reinforces the information’s relevance. Id. at *3.14
Medical providers will argue that their reimbursement rates and amounts accepted are trade secrets and protected from production. This argument fails based upon the case law cited in this article where the subject information and document was produced.15 All business information is not protected as a trade secret.16 However, most courts are inclined to enter into a confidentiality order restricting the information and use thereof to the subject litigation.17 It is best for the defendant to agree to limiting the use of the subject information to the subject lawsuit and stipulate to confidentiality.
Is the information admissible? Some judges continue to “put the cart before the horse” when ruling on the discovery of the information claiming that the information is eventually inadmissible under the collateral source rule. However, admissibility is an argument “for another day”. Nevertheless, the information should be admissible without mentioning insurance and violating the collateral source rule. Potential questions to a healthcare provider’s corporate representative include “if we analyze the majority of [the medical provider’s] average amount accepted as payment for the procedure code [CPT code at issue], what was the average accepted about during the years [the years your obtained in discovery]?” and “in reviewing [medical provider] documentation, you agree that in the last three years, the average amount accepted as payment from patients who received medical care with CPT code 22551 is $1,500 [the amount determined inthediscovery]?”. Suchquestionscompletelyavoidmentioningcollateralsourcesandinsuranceand therefore, should be appropriate to challenge the reasonableness of the medical providers charges.
In Lawton-Davis v. State Farm Mutual Automobile Insurance Co., 2016 WL 1383015, at *3 and *5 (M.D. Fla. Apr. 7, 2016), the middle district of Florida permitted evidence at trial relating to the reasonableness
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