2018 COA 125
Colo. Ct. App.2018Background
- Plaintiff Robert Forfar slipped and fell in a Wal‑Mart; jury awarded damages including $44,000 for medical services. Forfar is a Medicare beneficiary (eligibility via SSDI).
- Wal‑Mart sought to limit evidence of medical expense value to Medicare‑approved amounts, arguing providers were bound by Medicare limits and any private contracts were void under Medicare rules.
- Forfar moved to exclude evidence of Medicare benefits under Colorado’s collateral source rule; the trial court barred evidence of Medicare limits and private provider contracts but allowed evidence of the reasonable value of services (not tied to Medicare rates).
- After verdict, Wal‑Mart moved to reduce the award to Medicare accepted rates under § 13‑21‑111.6; the trial court denied the motion, applying the statute’s contract exception to Medicare benefits.
- Wal‑Mart appealed, arguing (1) pre‑verdict Medicare payments should define reasonable value, (2) post‑verdict the award must be reduced to Medicare rates, and (3) federal Medicare law preempts Colorado’s collateral source doctrine.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Medicare benefits are collateral source evidence pre‑verdict | Forfar: Medicare is a collateral source; amounts paid may not be admitted under § 10‑1‑135(10)(a) | Wal‑Mart: Medicare accepted amounts are dispositive of reasonable value and should be admitted | Held: Medicare benefits are collateral source; pre‑verdict evidence of Medicare amounts properly excluded |
| Whether verdict must be reduced post‑verdict under § 13‑21‑111.6 | Forfar: Medicare benefits fall within the statute’s contract exception (benefits paid due to SSDI/paid‑in system) | Wal‑Mart: No liability exists above Medicare limits so there is no ‘‘benefit’’ to deduct; thus reduction to Medicare rates required | Held: Medicare benefits fall within the contract exception; verdict need not be reduced to Medicare rates |
| Whether federal Medicare statutes preempt Colorado collateral source rule | Forfar: State collateral source law coexists with Medicare; no conflict | Wal‑Mart: Statutory language ("no person is liable") precludes tortfeasor liability for amounts above Medicare limits, so state law conflicts and is preempted | Held: No conflict preemption; Medicare statutes do not displace Colorado law as applied here |
| Whether appellate attorney fees should be awarded | Forfar: requests fees under § 13‑17‑102(2) | Wal‑Mart: appealed | Held: Fees denied — issues were novel and not wholly without merit |
Key Cases Cited
- Colo. Permanente Med. Grp., P.C. v. Evans, 926 P.2d 1218 (Colo. 1996) (describing collateral source rule principles)
- Kistler v. Halsey, 481 P.2d 722 (Colo. 1971) (early statement of collateral source concept)
- Barnett v. American Family Mut. Ins. Co., 843 P.2d 1302 (Colo. 1993) (SSDI benefits fall within contract exception)
- Van Waters & Rogers, Inc. v. Keelan, 840 P.2d 1070 (Colo. 1992) (employment‑related benefits fit contract exception)
- Volunteers of Am. Colo. Branch v. Gardenswartz, 242 P.3d 1080 (Colo. 2010) (insurer payments constitute a paid benefit for collateral‑source analysis)
- Kendall v. Hargrave, 349 P.2d 993 (Colo. 1960) (reasonable value is correct measure of medical damages)
- Berg v. United States, 806 F.2d 978 (10th Cir. 1986) (recognizing Medicare as collateral source when funded by Social Security taxes)