Judge Slashes Verdict in Suit That Could Impact Medicare Patients
Superior Court Judge Andrew Roraback shaved $72,129 from a jury verdict, leaving plaintiff Noella Doucet with a $163,942 award.
October 24, 2019 at 10:18 AM
4 minute read
Citing federal Medicare law and a reimbursement formula, a Superior Court judge has reduced a $236,072 jury verdict for a woman who suffered neck injuries in a car crash by $72,129, leaving the plaintiff with a $163,942 award.
Defense counsel said the case could set the tone for reducing future verdicts and settlements in litigation involving Medicare beneficiaries. But plaintiff counsel disagreed, saying there was other case law that contradicted the judge, and that might help Medicare beneficiaries.
The ruling stemmed from a suit by plaintiff Noella Doucet, a 77-year-old woman injured in a 2014 crash. Doucet's vehicle was rear-ended, and her lawsuit stated that she developed cervical facet syndrome, a degenerative condition resulting from injury to the ligament of the cervical facet joint in the neck.
Doucet is on Medicare. Her award from the Waterbury Superior Court jury had included about $190,000 in past and future damages, but the defense argued the amount was far more than Doucet's actual medical expenses.
And the court agreed, finding Doucet had sought reimbursement for expenses she could not collect under federal Medicare law.
The ruling reducing her verdict was necessary to address hiccups in how doctors and hospitals bill Medicare, according to defense counsel Larry Adler.
Adler represented driver Scott Jameson and co-defendant Durable Radiator & Auto Body Inc., whose company vehicle Jameson was driving at the time of the crash.
"Hospitals and doctors set arbitrary numbers to bill Medicare, and Medicare has a set contractual rate for what they pay and what the doctors are willing to accept," Adler said. "This [ruling] reduces the exposure to defendants to a more realistic number and a fairer number."
Adler, who filed the motion for remittitur to lower the jury award, called the award excessive.
"This lady did not have out-of-pocket expenses remotely related to what the jury awarded," he said. "What the judge did was reduce it to something more reasonably related to what the actual medical costs were."
The court agreed.
In his Oct. 1 ruling, Judge Andrew Roraback said he had no choice under federal Medicare law but to reduce the jury award.
"In the present case, the court concludes that the economic damages awarded must be reduced because these damages unlawfully included reimbursement for certain medical expenses claimed that are prohibited from being collected under federal Medicare law," the judge wrote. "The methodology that was used to calculate the economic damages award therefore is an award in excess of the lawfully recoverable cost of such care that is permitted as economic damages. … A remittitur of the amount of economic damages awarded is therefore warranted."
Doucet's counsel, Marc Ubaldi, saw things differently from the judge's ruling.
"We disagree with the ruling, as it totally flies in the face of the Connecticut Supreme Court's decision in Marciano v. Jiminez as well as the plain language of our collateral source statute and medical records statute," said Ubaldi, of the Waterbury Law Offices of Thomas E. Porzio LLC, in an emailed statement Thursday. "Fortunately for other plaintiffs, this is only a trial level decision and there are other Superior Court decisions that adhere to Marciano and properly apply the collateral source statute."
Adler of the East Hartford-based Adler Law Group Attorneys at Law LLC said he believes the ruling could have consequences beyond his clients' case.
"If other courts follow suit with this in similar cases, I believe it will lower the exposure for other cases both in settlement and trial," Adler said. "We can then look at what the actual costs paid for in medical services and treatment are as opposed to what is originally billed."
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