March 18, 2021
Hospitals Make Huge Profits By Rejecting Health Insurance in Car Accidents
Many patients are surprised to receive substantial emergency room bills after they are involved in auto accidents, despite the fact that they have health insurance that would have covered the hospital bill. According to a recent report in the New York Times, many hospitals are taking advantage of hospital lien laws that allow hospitals to place a lien on the patient’s personal injury settlement. By asserting a lien against the patient’s injury settlement, hospitals can avoid the contractual adjustments to their bills that are required when they accept health insurance. Instead, by placing a lien on the injury settlement, the hospital can collect amounts that can be five times higher, or more, than the amount that would have been allowed by the health insurance company.
The practice of hospitals foregoing their patients’ health insurance to seek higher payments from the patients’ injury settlement is especially common with low-income patients who have Medicaid. Medicaid’s reimbursement rates are typically significantly less than the reimbursement rates of private health insurance plans so hospitals have more to gain by pursuing a lien in Medicaid cases.
Consumer advocates decry the practice of asserting liens against the patient’s injury settlement in cases where the patient has health insurance, claiming that the hospital lien attaches to money that was intended to compensate the patient for their pain and suffering. While the patient’s injury lawsuit is pending, the hospital lien can adversely affect the patient’s credit. A lawsuit is currently pending against Tennova Healthcare Clarksville, a Tennessee hospital after the hospital pursued a lien against a veteran whose VA coverage would have paid the hospital’s emergency room bill. The lawsuit alleges that the hospital engaged in predatory lien practices. Some hospitals have emergency room patients sign a waiver, agreeing that the hospital can pursue a lien rather than billing the patient’s health insurance. Some patients have complained that they were asked to sign the waiver while waiting for treatment for serious injuries, even head injuries and that the waiver was not explained to them.
Hospital industry representatives argue that hospital liens properly shift the burden for the cost of accident-related treatment to the liability insurance for the wrongdoer. Industry representatives argue that this practice is particularly justified in cases where the patient is covered by Medicaid or Medicare because the negligent party, not the government, should be responsible for the cost of treatment.
February 24, 2021
COVID-19 Lawsuit Against Publix Allowed to Go Forward
On February 5, 2021, a Miami-Dade Circuit Court denied Publix’s motion to dismiss a wrongful death lawsuit filed by the family of a deli worker who died of COVID-19. The deli worker, Gerardo Gutierrez, had been exposed to the virus over two days in March of 2020 while working next to an employee who was displaying symptoms. According to the lawsuit, the Miami Beach Publix had prohibited Gutierrez and other employees from wearing masks. The lawsuit alleges that store managers were concerned that masks would “scare” customers.
Typically, under Florida law, when an employee is injured or killed while working, the employee or the employee’s heirs can only receive workers’ compensation benefits and cannot file a lawsuit. Workers’ compensation benefits include lost wages, medical expenses, and a limited lump sum death benefit. Because personal injury and wrongful death lawsuits can include compensation for physical and mental pain and suffering, these lawsuits can provide for significantly larger financial awards than workers compensation claims. There is an exception in Florida’s workers’ compensation law that allows workers to file personal injury or wrongful death lawsuits in cases where the employer intentionally injures an employee or acts in a manner that is certain to cause injury.
In seeking to have the lawsuit filed by Mr. Gutierrez’s estate dismissed, Publix argued that the lawsuit involved only allegations of ordinary negligence and that Publix should only be required to pay the workers’ compensation death benefit. Attorneys for Mr. Guttierrez’s estate argued that Publix misled employees to believe that they were safe without masks when Publix knew or should have known that the mask ban would increase employees’ risk of contracting COVID-19.
The lawsuit alleged that Mr. Gutierrez worked beside a female employee who had COVID-19 on March 27 and March 28. Mr. Guitierrez was hospitalized on April 10 and died on April 28. The United States Centers for Disease Control and Prevention didn’t recommend mask wearing for the public until April 3.
The court’s decision only means that the lawsuit can proceed to the initial stages. Publix will have another opportunity to ask the court to rule in its favor after depositions are taken. It is noteworthy that not one single Florida court has ever found the intentional act exclusion to the workers’ compensation law to be applicable and allowed an injured employee’s lawsuit against an employer to result in a final judgment in favor of the employee. Contact Tuttle Law, P.A., we are aggressive, experienced advocates who will not hesitate to go all out to protect you.