176 So. 3d 1247
Fla.2015Background
- Joerg seeks Supreme Court review of a Second District decision involving evidence of Luke Joerg’s collateral sources in a Medicare context.
- The Second District held that future Medicare benefits were unearned under Stanley and admissible to reduce future damages.
- Statutory damages are reduced by collateral sources under § 768.76, but Medicare/Medicaid are excluded from collateral sources when a right of reimbursement exists.
- Medicare has a primary payer structure (MSPA) making Medicare a potential subrogee with reimbursement rights from primary payers and settlements.
- The Court recedes from Stanley to hold future Medicare benefits constitute a liability due to reimbursement rights, affecting admissibility of such evidence.
- The Court remands for proceedings consistent with the opinion, preserving the rule that Medicare/Medicaid evidence is not admitted as collateral source.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Stanley applies to future Medicare benefits. | Joerg—Stanley should exclude Medicare as unearned. | State Farm—Stanley governs collateral sources, including Medicare, as unearned | No; Stanley is receded; Medicare benefits are a liability |
| Whether future Medicare benefits are admissible as collateral source evidence. | Joerg seeks exclusion of future Medicare benefits | State Farm seeks admission under Stanley | Future Medicare benefits are not admissible as collateral sources; they are a liability |
| What is the effect of MSPA and CMS subrogation rights on Medicare benefits in damages. | Medicare benefits should reduce damages only to the extent permitted by law | Medicare is a subrogee with right to reimbursement, thus not a collateral source | Medicare benefits create a liability and can be pursued for reimbursement; not a true collateral source |
| Are future collateral benefits subject to setoff under § 768.76(2). | Future benefits may be set off | Rudnick governs future benefits not subject to setoff | Future collateral benefits are not subject to setoff; setoff limitations apply |
Key Cases Cited
- Florida Physician’s Insurance Reciprocal v. Stanley, 452 So.2d 514 (Fla.1984) (establishes Stanley collateral source exception)
- Gormley v. GTE Prods. Corp., 587 So.2d 455 (Fla.1991) (collateral source rule and damages framework)
- Rudnick v. Allstate Ins. Co., 761 So.2d 289 (Fla.2000) (future medical payments and setoff limitations)
- Pollo Ops., Inc. v. Tripp, 906 So.2d 1101 (Fla.3d DCA 2005) (Medicare exclusion and subrogation rationale)
- Coop. Leasing, Inc. v. Johnson, 872 So.2d 956 (Fla.2004) (collateral sources and setoffs in damages )
- Velilla v. VIP Care Pavilion Ltd., 861 So.2d 69 (Fla.4th DCA 2003) (Medicaid benefits and Stanley considerations)
- Sheffield v. Superior Ins. Co., 800 So.2d 197 (Fla.2001) (inadmissibility of collateral source evidence; prejudicial effect)
- Parker v. Hoppock, 695 So.2d 424 (Fla.4th DCA 1997) (public benefits prejudicial; context of Stanley)
- Wills v. Foster, 892 N.E.2d 1018 (Ill. 2008) (Illinois rejection of Peterson-based Stanley rationale)
- Stalley v. Methodist Healthcare, 517 F.3d 911 (6th Cir.2008) (MSPA framework and primary payer structure)