Florida’s Supreme Court Decides that Plaintiffs Can Only Admit at Trial the Discounted Amounts of their Medical Bills Paid by Medicare

It has long been a hotly contested issue in Florida personal injury cases whether a plaintiff who is Medicare eligible and has had the benefit of Medicare paying part or all of his medical expenses can board the full or “gross” amount of the expenses at trial, even if Medicare paid for them. The leading Florida cases were Thyssenkrupp Elevator Corp. v. Lasky, 868 So. 2d 547 (Fla. 4th DCA 2003) and Cooperative Leasing, Inc. v Johnson, 872 So. 2d 956, 960 (Fla. 2d DCA 2004), out of Florida’s Fourth and Second District Courts of Appeal, respectively. The Thyssenkrupp court held that, “when a provider charges for medical service or products and later accepts a lesser sum in full satisfaction by Medicare, the original charge becomes irrelevant because it does not tend to prove that the claimant has suffered any loss by reason of the charge.” Less than a year later, the Second District Court held similarly in Johnson. See Cooperative Leasing, 872 So. 2d at 960. “[T]he appropriate measure of compensatory damages for past medical expenses when Plaintiff has received Medicare benefits does not include the difference between the amount that the Medicare providers agreed to accept and the total amount of the Plaintiff’s medical bills.”).

However, other districts and circuit judges within those districts would routinely disagree with the Thyssenkrupp/Johnson rationale. Often, trial court judges ruled that plaintiffs could board the full amount of expenses, even if they were paid at significantly lower amounts before trial by Medicare.

On April 28, 2022, The Florida Supreme Court handed down a significant opinion in Dial v. Calusa Palms Master Ass'n, Inc., 47 Fla. L. Weekly S115b (Fla. Apr. 28, 2022). The Supreme Court reviewed the Second District Court of Appeals decision in Dial v. Calusa Palms Master Ass’n, Inc., 308 So. 3d 690 (Fla. 2d DCA 2020), in which the Second District Court certified the following question of great public importance:

Does the Holding in Joerg v. State Farm Mutual Automobile Insurance Co., 176 So. 3d 1247 (Fla. 2015), prohibiting the introduction of evidence of Medicare benefits in a personal injury case for purposes of a jury’s consideration of future medical expenses also apply to past medical expenses?

Id. at 692

The Dial case arose from a negligence action, in which Elaine Dial sought to recover past medical expenses due to injuries she sustained when she tripped and fell on property owned by Calusa Palms Master Association, Inc. Prior to trial, the trial court granted the Association’s motion in limine and ordered that Dial was precluded from introducing as evidence at trial the gross amount of her past medical expenses and limited her to introducing only the discounted amounts paid by Medicare. After the jury awarded Dial $34,641.69 in past medical expenses, Dial appealed the ruling and argued that the Florida Supreme Court’s holding in Joerg v. State Farm Mutual Automobile Insurance Co., 176 So. 3d 1247 (Fla. 2015) allowed her to admit into the evidence the full amount of her past medical expenses.

In 2015, the Florida Supreme Court in Joerg specifically addressed whether the exception to the collateral source rule applied to future benefits provided by social legislation, such of Medicare. The Court further concluded that future Medicare benefits are both uncertain and a liability, due to the right of reimbursement that Medicare retains.

Now, in deciding Dial, the Supreme Court has distinguished future Medicare benefits and held that they are to be treated differently from past expenses paid by Medicare. The Florida Supreme Court answered the Second District Court’s certified question in the negative and approved the Second District’s approach of precluding evidence of gross medical expenses and limiting plaintiffs to introducing only the discounted amounts paid by Medicare. Dial v. Calusa Palms Master Ass'n, Inc., 47 Fla. L. Weekly S115b (Fla. Apr. 28, 2022).

Following this ruling, the practical approach is for the defendant to move in limine before trial to preclude the plaintiff “from introducing as evidence the gross amount of her past medical expenses and limit her to introducing only the discounted amounts paid by Medicare.” Dial v. Calusa Palms Master Ass'n, Inc., 47 Fla. L. Weekly S115b (Fla. Apr. 28, 2022).

A few things of note. First, often a Medicare-eligible plaintiff will have a health insurance supplement. In those cases, the supplement is paid for and, therefore, not an unearned benefit or a benefit “to all,” like Medicare is. In those cases, the Medicare-paid expenses will be treated differently from those covered by the supplement and, potentially, can be admitted in their gross amount.

Second, the Dial opinion specifically concerns Medicare. However, its rationale may and, in the proper circumstances, should apply to other unearned benefits, such as Medicaid and worker’s compensation benefits.

Dial is another win for the defense side in Florida, following previous victories in the legislature’s adoption of the Daubert standard and the Supreme Court’s adoption of the federal standard for summary judgment.