Monday, February 9, 2015

Mentioning Affordable Care Act at Trial Violates Collateral Source Rule

A recent trend in Pennsylvania personal injury matters involves defense counsel pointing to the Affordable Care Act to support an argument against any recovery of alleged medical expenses claimed by the Plaintiff.  The argument is that such expenses are or will be covered by insurance under the Affordable Care Act and therefore, they need not be awarded by a jury.

Plaintiffs argue that the well-settled Collateral Source Rule should preclude any mention of any benefits from a collateral source in an effort to preclude or diminish the recovery of compensation from the alleged wrongdoer.

While the Collateral Source Rule has been around for a while, the Affordable Care Act is a relatively new law.

By way of background and according to the Medicaid website, "[t]he Affordable Care Act  provides Americans with better health security by putting in place comprehensive health insurance reforms that will:
  • Expand coverage,
  • Hold insurance companies accountable,
  • Lower health care costs,
  • Guarantee more choice, and
  • Enhance the quality of care for all Americans.
The Affordable Care Act actually refers to two separate pieces of legislation — the Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) — that, together expand Medicaid coverage to millions of low-income Americans and makes numerous improvements to both Medicaid and the Children's Health Insurance Program (CHIP).
This section focuses on the major provisions of the Affordable Care Act related to Medicaid and CHIP. If you are interested in the law as a whole, you can:

The issue of whether the defense in a personal injury litigation may refer to the Affordable Care Act during the course of a jury trial was recently addressed in the case of Deeds v. University of Pennsylvania, No. 755 EDA 2014, 2015 Pa. Super. 21 (Pa. Super. Jan. 30, 2015 Lazarus, Wecht, and Strassburger, J.J.)(Opinion by Wecht, J.).

In Deeds, a defense verdict in a medical malpractice case was reversed and remanded for a new trial. 

On appeal, the Plaintiff argued, in part, that she was "entitled to a new trial because the trial court violated the collateral source rule when it 'improperly allowed [the Defendants] to inform the jury that [the Plaintiffs’] substantial medical needs were all being attended to at little to no cost to [the Plaintiffs’] legal guardian due to the existence of state and federal education and medical benefits programs.”  Op. at p. 4.  The defense referred to Medicaid as well as to how President Obama's Affordable Care Act would impact the future care costs in the case.

The Superior Court found these references at trial to be a patent violation of the long-standing Collateral Source Rule, the purpose of which is to "avoid the preclusion or diminution of the damages otherwise recoverable from the wrongdoer based on compensation recovered from a collateral source," and, as such, remanded the case for a new trial.

Anyone wishing to review this decision may click this LINK.

I send thanks to Attorney Paul Oven of the Moosic, PA office of the Dougherty, Leventhal & Price law firm for bringing this case to my attention.

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