The State of Plaintiff’s Past Medicare/Medicaid Benefits in Florida

Ever since the Florida Supreme Court decisionin Joerg v. State Farm Mut. Auto. Ins. Co., 176 So. 3d 1247, 1249 (Fla. 2015), the admissibility of Plaintiff’s past Medicare/Medicaid billing has been subject to debate.   In Joerg, the Supreme Court ruled “the trial court properly excluded evidence of Luke Joerg’s eligibility for future benefits from Medicare, Medicaid, and other social legislation as collateral sources.” Id. at 1257.  While the court did not render an opinion regarding past Medicare/Medicaid benefits, in footnote seven, the court cited to an Illinois Supreme Court decision which  “…also considered the admissibility of past Medicare benefits, not the future benefits at issue here. Wills, 323 Ill. Dec. 26, 892 N.E.2d at 1020. Given our agreement with the policy pronouncement in Wills, we do not consider this factual distinction relevant” Id.

Despite the seemingly clear ruling in Joerg, footnote seven has provided Plaintiffs an opportunity to argue that past Medicare/Medicaid benefits should be treated in the same manner as future benefits. This argument was recently addressed in Dial v. Calusa Palms Master Ass’n, Inc., 308 So. 3d 690, 691 (Fla. Dist. Ct. App. 2020), with the Second DCA affirming the trial court’s limitation of Plaintiff’s medical billing to that which was actually paid by Medicare.   The Fourth DCA has also addressed the issue and ruled that “Joerg did notimplicitly overrule cases barring evidence of the amount a medical provider billed when Medicare settled the debt for less. Gulfstream Park Racing Ass’n, Inc. v. Volin, No. 4D19-3471, 2021 WL 1997278, at *3 (Fla. Dist. Ct. App. May 19, 2021).   Despite seemingly clear rulings, the Second DCA and Fourth DCA both certified the following question to the Florida Supreme Court:

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?”

The Florida Supreme Court has since accepted jurisdiction of Dial v. Calusa Palms to address the question.  Until the Florida Supreme Court issues a ruling, Plaintiffs will be limited to introducing into evidence the amount of billing Medicare/Medicaid actually paid.  We will continue to monitor the case and issue further updates as it progresses. 

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