Another Court Applies Collateral Source Rule to Attempted References to Affordable Care Act in Civil Litigation Matters

In a recent decision out of the Western District Federal Court of Pennsylvania in the case of Welker v. Carnevale, No. 3:14-cv-149 (W.D. Pa. Jan. 13, 2017 Gibson, J.) (Mem. Op.), the court granted a Plaintiff’s Motion to Preclude the defense from presenting expert opinions and calculations based upon the Affordable Care Act with respect to the Plaintiff’s alleged damages for future life care cost.  

The Plaintiffs, relying upon several decisions from the state and federal courts, asserted that evidence of coverage under the Affordable Care Act is barred by the collateral source rule.  

The defense argued that the collateral source rule is inapplicable to the Affordable Care Act and that the decision cited by the Plaintiff was not binding upon this court.   The Welker court noted that while, to date, Pennsylvania Supreme Court has not weighed on this particular issues, several other courts upheld that calculations related to the Affordable Care Act are barred by the collateral source rule under Pennsylvania law.  The Welker court cited with a “see” signal the cases of Bernheisel v. Mikaya, No. 3:13-cv-01496, 216 W.L. 4211897 (M.D.  Pa. 2016); Cordes v. United States, No. 2:13-cv-547, 215 W.L. 10986360 (W.D. Pa. 2015); Deeds v. Univ. of Pennsylvania Medical Center, 110 A.3d 1009, 1013, reargument denied (2015) appeal dismissed sub. nom.  Deeds ex rel. Renzulli v. University of Pennsylvania Medical Center, 128 A.3d 764 (Pa. Super. 2015).  

While the Welker court agreed that none of these cases were binding upon it, nor was the issue discussed in any great detail in any of those opinions, the Welker court still found the decision to be instructive and was not persuaded that these decisions were wrongly decided.   

In a footnote, the Welker court also noted that the decisions issued in the above cited cases were issued prior to recent political events “which cast the long-turn existence of the ACA into doubt.   The case for excluding calculations based upon the ACA is only stronger now.”  

 

Anyone wishing to review a copy of this decision may click this LINK.  

 

I send thanks to Attorney Scott Cooper of the Harrisburg office of Schmidt Kramer for sending this case to my attention. 

 

 

Judge Nealon of Lackawanna County Addresses Admissibility of Affordable Care Act to Challenge Claim of Future Medical Expenses in a Malpractice Action

In his recent decision in the case of Vaccaro v. Scranton Quincy Hospital Company, LLC, No. 2014-CV-7675 (C.P. Lacka. Co. Oct. 24, 2016 Nealon, J.), Judge Terrence R. Nealon of the Lackawanna County Court of Common Pleas addressed the issue of the admissibility of the Affordable Care Act to challenge a Plaintiff’s future life care plan damages evidence.  

This matter pertains to an obstetrical and hospital negligence claim.   The Defendant-obstetrician filed a Motion In Limine seeking leave of court to introduce evidence and cross-examine the Plaintiffs’ economic damages experts on the provisions of the Patient Protection and Affordable Care Act, which requires individuals to purchase health insurance and establish limits for annual out-of-pocket expenses.

The defense asserted that these new health insurance provisions provide grounds to reconsider and renounce the common-law collateral source rule that bars evidence of any payments made by a collateral source on behalf of a Plaintiff.  

Judge Nealon noted that, although Section 508(a) of the MCARE Act generally bars a Plaintiff from recovering damages for past medical expenses that are covered by a collateral source Section 509, governing claims for future medical expenses, does not contain comparable language abrogating the collateral source rule for future medical expenses claims.  

Judge Nealon also noted that the only relevant appellate precedent issued by the Pennsylvania Superior Court in the case of Deeds v. University of Pennsylvania Medical Center, 110 A.3d 1009 (Pa. Super. 2015), appeal dismissed, 128 A.3d 764 (Pa. 2015),  resulted in a decision that referenced to the Affordable Care Act’s provisions in malpractice litigation constitutes “a patent violation of the collateral source rule.” 

Accordingly, Judge Nealon denied the Defendant’s Motion In Limine.  

Anyone wishing to review Judge Nealon's decision in Vaccaro may click this LINK.

Cross-Examination of Life Care Planning Expert on Affordable Care Act Precluded by Collateral Source Rule

In his recent decision in the case of Bernheisel v. Mikaya, No. 3:13-cv-01496 (M.D. Pa. Aug. 9, 2016 Mariani, J.), Judge Robert D. Mariani addressed a number of Pre-Trial Motions in Limine filed by Defendants in this medical malpractice action including a request for a bifurcation of trial and motions seeking to preclude and limit medical expense and future economic damages claims.  

The Opinion is notable with respect to Judge Mariani’s recitation and application of Federal Rule of Civil Procedure 42(b) pertaining to motions to bifurcate trials.   Here, the Defendants requested a bifurcation of the liability issues from the damages issues.   Using his broad discretion on the matter, Judge Mariani denied this motion.  

With regards to the Motions pertaining to the economic damages claims, Judge Mariani ruled, in part, that he would defer ruling on the Defendant’s Motions relative to the Plaintiff’s medical cost claims until the time of trial.   The Court did generally note that Pennsylvania law requires the Plaintiff to produce evidence which establishes this type of claim with reasonable certainty and does not require the Plaintiff to establish a precise amount of damages.  

The Defendants also sought the permission of the court to cross-examine the Plaintiff’s life care planning experts on the future medical expenses claims by crossing the expert and introducing evidence pertaining to Medicaid, Medicare, and the Affordance Care Act.  

Judge Mariani, citing, in part, to the case of Deeds v. University of Pennsylvania Medical Center, noted that the collateral source rule precludes counsel from pursuing certain inquiries, including raising an individual’s access to Medicare, Medicaid, and benefits under the Affordance Care Act when opposing a future medical expenses claim.  

As such, the court in Bernheisel precluded the defense from cross-examining the Plaintiff’s life care planning expert on these issues.  

Anyone desiring a copy of this decision may click this LINK.

To review the February 9, 2015 Tort Talk post on the Deeds v. University of Pennsylvania Medical Center case, which contains a Link to that decision, click HERE.

The prevailing Plaintiff’s attorney in this matter was Attorney Max Kennerly, Esquire of the Philadelphia law firm of Kennerly Loutey, LLC.  I send thanks to Attorney  Michael A. O’Donnell of the Kingston, Pennsylvania O’Donnell Law Offices for bringing this decision to my attention.   

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:

• Read the Compilation of the Affordable Care Act, or
• Review the law by section."

Source: http://medicaid.gov/affordablecareact/affordable-care-act.html

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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