THE HILLSBOROUGH COUNTY HOSPITAL AUTHORITY, OPERATING TAMPA GENERAL HOSPITAL, HILLSBOROUGH COUNTY, FLORIDA, APPELLANT,
v.
PEGGY AULD FERNANDEZ, APPELLEE
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Tampa General Hospital appealed a trial court's reduction of its hospital lien by 38% based on evidence that managed care payors received contractual discounts. The Florida District Court of Appeal reversed, holding that evidence of contractual discounts alone is insufficient to prove hospital charges are unreasonable under the statutory lien statute.
Evidence of contractual discounts received by managed care payors, standing alone, is insufficient to prove that a hospital's charges are unreasonable. The trial court erred in reducing the hospital's lien based solely on this evidence.
[1] Evidence of contractual discounts provided to managed care payors, standing alone, is insufficient to prove that a hospital's charges are unreasonable for the purpose of…
[2] A statutory lien for hospital charges may be reduced only upon a showing that the charges themselves are unreasonable, not merely that discounts were offered to other par…
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Join FLexlaw to unlock all legal intelligence“The authority shall be entitled to a lien for all reasonable charges for hospital care and treatment of ill or injured persons upon any and all causes of action, suits, claims, counterclaims and demands accruing to the persons or legal representatives of the persons to whom such care or treatment are furnished and upon all judgments, settlements and settlement agreements entered by virtue of such illness or injury”
Statutory language defining the hospital's lien right, requiring charges to be 'reasonable'
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Join FLexlaw to unlock all legal intelligencePeggy Auld Fernandez was injured in an automobile accident and received treatment at Tampa General Hospital without insurance or ability to pay. Tampa…
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BLUE, Judge.
The Hillsborough County Hospital Authority, operating Tampa General Hospital (“Tampa General”), contends the trial court erred in finding the hospital’s charges to be unreasonable and in reducing the hospital’s hen by thirty-eight percent. Because we conclude the evidence was insufficient to support the trial court’s ruling, we reverse.
Peggy Auld Fernandez was injured in an automobile accident and received treatment at Tampa General. Fernandez had no medical insurance or ability to pay but was pursuing a claim for personal injuries arising from the accident. Consequently, Tampa General asserted a statutory hen for its charges in Fernandez’s personal injury case.1
The authority shall be entitled to a lien for all reasonable charges for hospital care and treatment of ill or injured persons upon any and all causes of action, suits, claims, counterclaims and demands accruing to the persons or legal representatives of the persons to whom such care or treatment are furnished and upon all judgments, settlements and settlement agreements entered by virtue of such illness or injury-
Ch. 80-510, § 17, at 149, Laws of Fla. (emphasis added).
After settling her personal injury claim, Fernandez challenged the reasonableness of the hospital’s charges. Fernandez argued that the charges were unreasonable because Tampa General entered contracts with managed care payors2 whereby they received discounts from Tampa General for treatment of their plan participants.
The trial court found that the hospital’s charges were unreasonable and based this determination solely on evidence that managed care payors receive a discount. We hold that evidence of these contractual discounts, standing alone, is insufficient to prove that Tampa General’s charges were unreasonable. Accordingly, we reverse the trial court’s order reducing the hospital’s lien by thirty-eight percent.
Our decision that the trial court did not have before it sufficient evidence to reduce the hospital’s hen renders Tampa General’s second issue moot. On remand, the trial court shall reinstate the hospital’s hen for the full amount of its charges.
CAMPBELL, A.C.J., and SCHOONOVER, J., concur. . The legislature created the Hillsborough County Hospital Authority and provided in part:
. Although referring principally to health maintenance organizations and preferred provider organizations, the evidence also pertained to discounts received by Medicare, Medicaid and workers' compensation.
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Goble v. Frohman, 848 So. 2d 406 (Fla. 2d DCA 2003)…more, as this court has previously held, evidence of contractual discounts received by managed care providers is insufficient, standing alone, to prove that nondiscounted medical bills were unreasonable: Hillsborough County Hosp. Auth. v. Fernandez, 664 So. 2d 1071 (Fla. 2d DCA 1995). Therefore, we affirm the exclusion of evidence at trial regarding collateral source benefits. Because this case presents an issue of great public importance, we certify to the Florida Supreme Court the following question: UNDER…
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Colomar v. Mercy Hosp., Inc., 461 F. Supp. 2d 1265 (S.D. Fla. 2006)…open pricing term (like the price of Mercy’s services in the contract) must be reasonable, Florida law requires more than mere allegations of differential pricing to establish unreasonableness. See Hillsborough County Hosp. Auth. v. Fernandez, 664 So.2d 1071, 1072 (Fla. 2d DCA 1995) (“evidence of these contractual discounts [to Medicare patients and the like], standing alone, is insufficient to prove that Tampa General’s charges were unreasonable.”). Therefore, the Court dismissed Plaintiffs FAC, but gr…1 / 2
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Triolo v. United States (M.D. Fla. 2022)…t does identify one charge in Pardo’s records that appears to reflect a discounted rate paid by PIP, but this evidence, standing alone, does not persuade the Court that the charges were unreasonable. See Hillsborough Cnty. Hosp. Auth. v. Fernandez, 664 So. 2d 1071, 1072 (Fla. 2d Dist. Ct. App. 1995) (holding that evidence of “contractual discounts, standing alone, is insufficient to prove that [hospital’s] charges were unreasonable”); see also Lawton-Davis v. State Farm Mut. Auto. Ins. Co., No. 6:14-cv-1157-O…
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