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Did the Georgia Supreme Court Open the Door for a Personal Injury Defendant to Challenge the Reasonableness of a Plaintiff’s Medical Bills?

Posted on: June 24th, 2015

By: Abby A. Vineyard

Last week, the Georgia Supreme Court held that, where a lawsuit involves a question as to the validity of a hospital lien for charges for a patient’s care, the patient challenging the reasonableness of the charges is entitled to discover information relating to the amounts the medical provider charged other patients for similar care.  Bowden v. The Medical Center, Inc., No. S14G1632, 2015 WL 3658819 (Ga. June 15, 2015).

Danielle Bowden, who was uninsured, was treated at The Medical Center for injuries sustained in a car accident.  The Medical Center billed Bowden a total of $21,409.59 for her treatment and filed a hospital lien for the same amount.  After litigation ensued, Bowden filed a cross-claim against The Medical Center alleging “…her bill of $21,409.59 was grossly excessive and did not reflect the reasonable value in the community of her treatment.”

Bowden sought to discover information relating to how much The Medical Center charged other patients for similar treatment during the same time period.  The Medical Center objected and refused to provide the information, but the trial court granted Bowden’s motion to compel the information.  The Georgia Court of Appeals reversed the trial court’s order, agreeing with The Medical Center that the information sought was not relevant to Bowden’s claims.

The Georgia Supreme Court reversed the Georgia Court of Appeals’ opinion, holding that “the discovery Bowden sought may have some relevance to the reasonableness of [The Medical Center’s] charges for her care, and thus, assuming no other objections to her various requests are made and sustained…Bowden is entitled to see what the information and documents show and whether they support her claims and defenses.”  The Court emphasized that its ruling only applies to the discovery, rather than the admissibility, of the amounts medical providers charge other patients for similar care.  It reasoned that the concept of “relevance,” in the discovery context, has been broadly construed to mean “matter that is relevant to anything that is or may become an issue in the litigation.”

The Court’s decision opens the door for a lien defendant to challenge the validity of a hospital lien.  This decision raises a few interesting questions in the context of personal injury cases.  Can an insurer and/or a defendant in a personal injury case now challenge the reasonableness of the plaintiff’s medical bills, especially when the plaintiff is uninsured?  Will this lead to the amounts charged for other patients’ treatment being admissible at trial rather than only being discoverable?  Since medical providers have contracts with insurers under which they routinely accept a heavily-discounted percentage of the billed amount, will it be easier to argue that the actual billed amount is not reasonable?  It will be interesting to see if the Court expands its ruling when these kinds of issues are inevitably presented for the Court’s consideration.

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