Excessive or “Phantom” Damages in Georgia Personal Injury Claims
Jay Eidex – Partner
Groth, Makarenko, Kaiser & Eidex
May 20, 2024
I. The Problem
For those practicing personal injury law in Georgia, we are all well aware of the dramatic rise in medical specials that are now being presented at trial. We are also well aware of the increase in jury verdicts we have seen across the country, which have been shown to be rising 51.7% annually from 2010 to 2018, while overall inflation grew only 1.7%. [1] We have seen a significant rise in the number of very large (i.e. “nuclear”) verdicts in Georgia as well, as is reflected in the below graph. [2]
A significant driver in the increase in these verdicts is owed to an increased amount in medical special damages presented at trial. As many of us have observed, it has become common to see excessively large medical special damages, despite limited treatment, often involving basic physical therapy and perhaps some limited injections.
These inflated damages have been described as “’Phantom Damages,” which has been defined as those damages “exist[ing] any time lawsuit recoveries are calculated using the dollar amount a patient was billed for a medical service instead of the amount the patient, their insurer, Medicare, Medicaid, or workers’ compensation actually paid for treatment.” [3]
These phantom damages are presented in at least two identifiable instances: (A) through charge master billing statements, and (B) through billing statements created as the result of “Letters of Protection” (i.e. health provider liens). These instances are described below:
A. Chargemaster Billing Statements
The Georgia Supreme Court, in Bowden II, has defined “chargemaster” as follows:
“Hospitals… set their rates by calculating a “chargemaster rate,” like the sticker price of a new car, for each service provided, and that rate applies to all patients receiving that particular service. The hospital determines its chargemaster rate by factoring in the cost of the service along with the overall costs of operating the hospital. Every patient is charged the chargemaster rate, but very few patients actually pay that amount because insurance companies, including Medicare, Medicaid, and other third-party payers, negotiate a reduced reimbursement rate. Thus, for patients with insurance, the insurance company will reimburse TMC pursuant to the negotiated rates. Additionally, Medicare and other government programs have a set methodology used to calculate their reimbursement amounts.” [4]
In the Bowden case, the patient sued the hospital for having filed a lien in an amount the patient thought excessive. The rate the hospital had charged was the chargemaster rate, a rate that the hospital rarely, if ever, was compensated for the treatment provided. The patient argued that since the lien amount did not represent the amount typically received for the medical services rendered, the hospital was committing fraud when it demanded payment for such an amount.
The Court ultimately dismissed the Plaintiff’s suit, but it did find as follows:
“Patients without any insurance or third-party payment source are billed the full chargemaster rate. For the relevant years pre-dating this lawsuit, the percentage of TMC patients who paid less than the chargemaster rate was 98.84 percent, while only 1.16 percent paid the full rate. Regardless of the reimbursement scheme, and despite the chargemaster rates, TMC collects, on average, about 33 percent of the chargemaster rate.
To place this rate in context, [because] … Bowden’s bills totaled approximately $21,000[,] [and] [b]ecause she lacked any insurance, she was billed that full amount. Had she been covered by Medicaid, the hospital would have received $9,895.24 for reimbursement. Medicare would have reimbursed $11,238.11, and Blue Cross/Blue Shield PPO would have paid $10,644.” [5]
This finding should be concerning to anyone who is being asked to pay the full amount of the chargemaster rate. The Court found that the full billed amount submitted by the hospital was only paid by patients 1.16% of the time and that the hospital’s true average recovery was approximately 33% of the chargemaster rate. Despite that fact, the hospital filed a lien against its patient for the full chargemaster rate. The Supreme Court was unmoved by its own findings and held that summary judgment should have been granted to the hospital. The Court reasoned that the Plaintiff was free to argue the charges were not reasonable, but he could not allege outright fraud in filing the lien for the chargemaster rate. It held that there was sufficient evidence in the record to support that the chargemaster rate reflected the “the cost of the service along with the overall costs of operating the hospital,” and so the chargemaster was not fraudulent as a matter of law. It is not clear how the Court found the hospital’s position that the chargemaster rate was necessary to operate the hospital persuasive, given that the hospital was in fact able to operate when receiving only 33% of that amount.
Other available industry data is consistent with the Supreme Court’s finding. It has been shown that Medicaid reimburses only 25% of the billed charges. Medicare reimburses only 28% of the billed charges, and commercial insurers reimburse only 53% of the billed charges. [6] Despite all of this data and the Supreme Court’s finding in Bowden II, it is routine practice to use the chargemaster bills for the jury to consider without offering the jury any understanding that those bills are not what the hospital ever expected to receive.
B. Letters of Protection
A “letter of protection” has been defined as “any arrangement by which a health care provider renders treatment in exchange for a promise of payment for the claimant’s medical expenses from any judgment or settlement of a personal injury or wrongful death action. The term includes any such arrangement, regardless of whether referred to as a letter of protection.” [7] These types of agreements are typically found in the medical records from medical providers in personal injury suits and they may be referred to as “Lien Agreements,” “Assignment of Benefits” or might have other names, but they all have the same thing in common: the medical provider maintains a lien on the final settlement or verdict in the litigation. These agreements typically contain language that states, in substance, the following:
“Patient hereby irrevocably authorizes and directs any insurance company, attorney, entity, and or individual to whom an original or copy of this Agreement is provided to withhold from Patient and pay directly to Provider or its designee or assigns an amount up to the Total Billed Charges from any litigation/settlement proceeds which may in include insurance proceeds from any settlement, settlement agreement, judgment, compromise, award, verdict, and/or recovery of proceeds in Patient’s favor as may be necessary to fully pay any and all financial obligations by Patient to Provider or its assigns for the Healthcare Services provided hereunder.” [8]
In exchange for this agreement, the provider foregoes charging the patient as services are rendered and awaits the final resolution of the case before seeking payment.
The problem with such an agreement is that the treatment provided is not subjected to review by an insurer or other sophisticated entity nor are the billed amounts determined by market forces. That is, unlike in an instance where an insurance company or Medicare were involved, bills created by providers involved in tort suits can claim them for any amount without being subjected to pre-approval processes or upon what private pay patients might be able to pay. A patient in a personal injury suit has no way of assessing the reasonableness or necessity of the treatment, but just accepts whatever the provider sets forth and leaves its payment to his personal injury lawyer to negotiate and disperse through the settlement proceeds. In the tort environment, it is significantly to the medical provider’s benefit to provide as much treatment as possible and to charge as much as possible because the only reviewing entity will be the jury, and it will have limited knowledge in what procedures and billing practices are truly reasonable and customary, resulting in many jurors to just accept the bill provided by the provider as reasonable.
II. The Cause and Result
The reason these phantom damages have found their way into the tort system is obvious to the practitioner. It is because the higher the medical special damages are that are submitted, the higher value the claim has. Medical special damages increases serve to increase jury awards, not only because the jury might award these increased amounts to compensate the Plaintiff for those expenses, but they also increase the amount of pain and suffering damages as well. There is a strong statistical correlation between pain and suffering damages and the amount of medical expenses. The relationship has been shown to be close to linear. [9] This is to say that an injured party is heavily incentivized to increase his medical bills if his objective is to increase his recovery, revealing itself with increased awards for special damages and general damages.
There is also statistical evidence supporting the argument that as liability limits increase, the value of those claims under the higher policies also increase. [10] The data also shows that in states where the disclosure of liability limits is required, the cost of premiums rise. [11] The significance of this data is that it shows that Plaintiffs have successfully arrived at a way to maximize their recoveries, first by determining the amount of recovery available to them (i.e. by determining the amount of coverage) and second by increasing their treatment and medical bills up to the amount of that policy. That is, plaintiffs have realized that an increase in medical special damages up to the amount of the policy limits is an effective way to increase overall recovery. The question then is how defense attorneys are to respond to the increased medical special damages that are being submitted to juries. Some such ways are proposed in the following section of this paper.
III. Potential Solutions
A. Legislative or Judicial Fixes
The statistical data should come as no surprise to the practitioner whose observations support the conclusion that a higher policy limit generally equates to a higher amount of medical specials and a higher amount of medical specials equates to a larger amount of non-economic damages awarded. These statistical conclusions and anecdotal observations support an argument that a meaningful way to reduce jury verdicts is to limit the disclosure of policy limits to the claimant and to eliminate the over-statement of medical special damages. Other states have reformed their tort systems to some degree by, among other things, limiting phantom damages and to denying claimants the right to know the tortfeasor’s liability limits. [12]
Allowing juries to know the actual amount paid by the Plaintiff’s health insurer is not possible in Georgia due to the collateral source rule. [13] While it might seem a logical way to determine the value of the services by looking at the amount paid by the insurer, that is not something Georgia law will allow, and changing the collateral rule in Georgia would require a constitutional amendment, as the Georgia Supreme Court has held that it arises out of a matter of constitutional right. [14]
The judicial and legislative environment in Georgia is considered poor for civil defendants, having earned it the 2022/2023 designation as the number one “Judicial Hellhole.” [15] Whether rightfully number one in that regard, the general sentiment among certain observers is that Georgia’s statutes and its judges make for a Plaintiff friendly venue, so much so that it was felt its civil litigation environment was worse for defendants than in the other 49 states.
B. A Thorough and Sifting Cross Examination
1. Cross of the Plaintiff
Georgia does have a very broad right to cross examination of all parties and witness, and successful cross-examinations of witnesses are often the key to a favorable verdict. It is often the Plaintiff himself who attempts to tender in the medical bills, and the law provides the defense to a full cross examination of him on those bills.
O.C.G.A. 24-9-921 states:
“(a) Upon the trial of any civil proceeding involving injury or disease, the patient or the member of his or her family or other person responsible for the care of the patient shall be a competent witness to identify bills for expenses incurred in the treatment of the patient upon a showing by such a witness that the expenses were incurred in connection with the treatment of the injury, disease, or disability involved in the subject of litigation at trial and that the bills were received from: (1) A hospital; (2) An ambulance service; (3) A pharmacy, drugstore, or supplier of therapeutic or orthopedic devices; or (4) A licensed practicing physician, dentist, orthodontist, podiatrist, physical or occupational therapist, doctor of chiropractic, psychologist, advanced practice registered nurse, social worker, professional counselor, or marriage and family therapist.
(b) Such items of evidence need not be identified by the one who submits the bill, and it shall not be necessary for an expert witness to testify that the charges were reasonable and necessary. However, nothing in this Code section shall be construed to limit the right of a thorough and sifting cross-examination as to such items of evidence.” Emphasis added.
The foundation for the admission of the medical bills through the Plaintiff is simply that the Plaintiff state the billing statement are the ones generated from his treatment and that the document purporting to be a bill represents the amount billed. In the case of Arnold v. Liggins, [17] the court held that where a Plaintiff could identify the insurance claim form (which was not actually the bill created for the patient) as being the amount that was billed, that was sufficient for it being admissible. The court reasoned that there was no evidence that the form misled the jury or that it inaccurately set forth the amount of the billed charged, and that any issues as to its weight could have been addressed on cross examination. Similarly, the simple fact that the patient might not have been mailed the bills is not a sufficient basis for their exclusion if the Plaintiff is able to testify they reflect the treatment charges. [18]
The significance of this statute and the caselaw is that (1) it allows the bills to be admissible with very little foundation being laid as to their legitimacy, and (2) it allows for extensive cross-examination of the Plaintiff so that the jury can determine what weight to afford that testimony. For that reason, if there is a question as to the legitimacy of the amount of the bill, the only method one has to attack it is through cross-examination of the Plaintiff regarding the lack of evidence supporting the reasonableness of the bill. The cross-examination of the Plaintiff would also be an opportunity to ask questions about whether this provider was the result of an attorney referral because that would add additional questions for the jury to consider regarding whether the bill is legitimate or whether it had been inflated for the purposes of trial. The admissibility of the attorney/doctor referral is subject to a relevancy analysis that will not be disturbed unless there can be shown to be an abuse of discretion. [19] Its admissibility is therefore fact and judge dependent, which means it is possible to introduce this evidence at trial given the correct circumstances.
2. Cross of the Medical Provider
a. Cross of the Physician
Physicians typically are able to provide testimony that their bills are reasonable and customary, but they often have a limited basis for explaining how they know this information. Few physicians review their own bills or play a role in setting their fees. Those issues are usually left to the mangers of their offices. At least some question might be asked of the provider regarding his familiarity of the billing amounts, as opposed to just allowing the physician to testify entirely unchallenged.
In addition to a cross-examination as to the reasonableness of the fees, the physician should also be cross-examined with regard to his lien on the settlement (as discussed in paragraph I.B. above) if one exists. Georgia courts have held that the exclusion of the lien document for the purpose of cross-examining the physician as to his bias is error. [20] The fact that the physician’s payment for his services is contingent upon the jury’s verdict and may therefore bias his testimony in favor of securing a larger verdict for the Plaintiff (and a larger payout to the physician as well) has been held to be legally relevant for the jury’s consideration.
b. Cross Examination of the Billing Department
Another method to attack on the billing statements would be to depose the medical records custodian. The object of the deposition would be to decipher the true amount the facility charges for that service. Georgia law requires that the amount charged by the medical facility be “reasonable and necessary” in order for it to be awardable. [21] A reasonable line of attack would therefore be to question whether the amount billed in the instant case is consistent with the amount received from other patients.
The legal basis for such an attack arises from the holding in the case of Bowden v. The Medical Center. [22] Bowden I first appeared before the Supreme Court in 2015 and then Bowden II appeared before the Supreme Court in 2020. The issue in the Bowden case arose from a dispute over the lien filed in the amount $21,409.59 for the treatment the hospital provided. Mr. Bowden felt the charge unreasonable and he sued for fraud and under the RICO statute, submitting that The Medical Center was engaged in a pattern of defrauding patients for inflated amounts for medical treatment in amounts far beyond what they ever received for providing that treatment to most any other patient. The case first reached the Supreme Court in Bowden I, where a dispute arose over whether Mr. Bowden could rightfully discover the true amount The Medical Hospital typically recovered from its chargemaster bills. [23] The Court held:
“Where the subject matter of a lawsuit includes the validity and amount of a hospital lien for the reasonable charges for a patient’s care, how much the hospital charged other patients, insured or uninsured, for the same type of care during the same time period is relevant for discovery purposes.” [24]
That is, a party has the right to discover that evidence. The Court specifically does not say that the evidence once discovered is admissible as evidence, but it only provides the right to discover it.
The question of admissibility is another matter. Some federal district court cases have rendered orders indicating that the Georgia collateral source rule [25] will limit the ability of a Defendant from referencing negotiated rates between insurers, Medicaid, and Medicare when determining the reasonable amount to be charged. In the case of Houston v. Publix Supermarkets, [26] the court held that the amount a litigation finance company actually reimbursed the provider was admissible, despite the fact that the finance company had submitted bills in excess of that amount to the Plaintiff for payment. The court drew a distinction therefore between healthcare insurers and finance companies in its collateral source analysis. In the case of Gaddy v. Terex Corp, [27] the court held that “the reasonable value of Plaintiff[s’] medical care based on the average rates paid in the market by all payers” was admissible, even though many of those payments were made by insurers. This holding is limited to allowing in evidence of the actual amounts the provider has received from other patients in order to determine the true customary rate charges, but it is not taken to mean that for the actual plaintiff in the case, the defense could reveal the amount his insurers paid for the procedure. Consistent with the Gaddy holding, the court in Compton v. Bach, [28] held that it would violate the collateral source rule to admit into evidence the amounts paid by Medicare and other insurers for the specific treatment provided to the Plaintiff, but again, the typical amounts charged for those procedures by looking at payments received from all payers generally would be admissible.
In Bowden II, the Supreme Court then took head on the merits of the Plaintiff’s suit and ultimately held that the claims for fraud and for RICO violations against The Medical Center were subject to summary judgment. It reasoned that regardless of whether The Medical Center’s lien was reasonable, sufficient uncontradicted evidence existed that it was not fraudulent. In so ruling, it over-ruled two prior Georgia Court of Appeals precedents. [29]
C. Billing Experts
One way defendants have attempted to counter inflated billing statements is through the hiring of billing experts. A billing expert ideally will be an expert who will have available to her a statistically valid database of billings submitted by regionally relevant medical providers that can be compared to the billing statements provided by the Plaintiff. The expert witness should be able to testify knowingly about how that data is collected and how it has been verified as reliable. These comparisons can be helpful to a fact finder in understanding how significantly the bills have been inflated.
Typically a billing expert will provide comparative bills that are in 75th percentile of what is typically charged when comparing them to the Plaintiff’s bills. To explain what this means, consider if a Plaintiff had a bill for $10,000 and the billing database showed that $5,000 represented the amount charged by similar providers in the 75 th percentile, that would mean that only 25% of the medical providers charge more than $5,000 for that procedure. By using the 75 th percentile and not the 50 th (the mean), the defense would be using a far more conservative comparative figure and the reliance upon that figure would be less subject to attack on cross examination.
The effectiveness of such experts is difficult to evaluate in terms of whether jurors find their testimony believable and persuasive, but they do directly address the issue of the reasonableness of the inflated bills, although they do not directly attack the chargemaster rates. Since the inflation of the bills is so rampant, Defendants would benefit if they were able to pay the chargemaster rate as opposed to the even more inflated rates of those providers working on liens.
D. Claims Handling Changes
As most of the suggestions have made clear, the only effective way of ultimately defeating excessive billing practices is by refusing to pay them and then defending against them at trial. As noted in the graph in Paragraph I above, the decision to try cases comes with significant risks in terms of a resulting large verdicts. In fact, as of the time of writing this paper, a Cobb County jury just handed down a verdict in a car accident case resulting in a verdict of $80,000,000. [31] This litigation environment places insurers in the difficult position of having to over-pay all claims for fear that a single verdict will wipe out decades of prudent, well adjusted claims payments. Those over-payments then exasperate the problem, with more personal injury attorneys and claimants entering the market for larger and larger settlements.
Additionally, the consequences to an insurer and an insured in not paying policy limits when the medical bills approach or exceed policy limits, regardless of how inflated the medical bills might be, can be devastating if a subsequent jury finds the denial of the claim made in bad faith. Not only might they be required to pay the full amount of the judgment regardless of policy limits, but they may also be subject to bad faith damages. [32] This leaves insurers over-paying claims due to what they know to be inflated bills because they fear a jury might accept the bills as valid and a subsequent jury might consider their denial of the claim to be bad faith.
This litigation environment makes it very difficult to combat cases with high medical special damages when they approach the policy limits, so it is understandable why insurers are hesitant, or at least very cautious, in taking this approach. What is clear, however, is that the Georgia Courts are committed to leaving questions about the value of each case to the juries, so, for the time being, the value of the medical service is whatever the 12 jurors say it is, with their decision being based upon whatever they are able to learn and understand about the medical billing process during their few days as jurors.
E. Changes to the Medical Payout System
Much has been written regarding how a universal healthcare system would impact the American tort system. [33] While this would not be a direct change to the tort system, indirectly it would likely have far reaching impacts. That is, if injured parties received medical treatment through a government sponsored or paid program, the necessity in providing that compensation through a separate tort system would become limited, and the awards would likely be subject to repayment through the filing of government enforced liens. The role of the physician who worked on a lien or of a chargemaster fee would likely become obsolete. It would also be difficult to explain to a juror why a Plaintiff would be entitled to compensation for medical special damages if the juror knew the bill had already been paid.
While there does not appear to be a current push for true universal healthcare, to the extent that does occur, it should be expected to be disruptive to the current tort system, especially regarding the issues discussed in this paper. Nothing said here is meant to enter into the debate over whether universal healthcare would be preferable to our current system, but it is meant only to point out that changes to the way the government involves itself in the healthcare system will have impacts on state tort systems. In fact, it could be argued that changes to the healthcare payout system would have the most far-reaching effects on the tort system than any other legislative change, a consideration that is often not considered in debates about the changes to the health insurance structure in the U.S.
F. Closing Arguments
The final critical stage that cannot be overlooked in defending the claim against excessive billing practices in how the defense addresses these issues in closing argument. In years past, much of closing argument in motor vehicle collision cases centered around negligence (if it was even in dispute) and then upon proximate causation (i.e. whether did this accident caused these alleged injuries?). What is suggested in this paper is that a focus on the amount of and reasonableness of the damages needs to be a central component in the defense of some of these inflated damages cases. This focus might be a shift in the way many defense attorneys are used to practicing, but, with the bills becoming so inflated, real efforts must be used to combat them. At a minimum, an attack on the amount of damages also serves to inform the jury of the illegitimacy or exaggerated nature of the claim, and that can have effects beyond the issue of damages, meaning it might result in the juries questioning the extent of the Plaintiff’s injuries as well.
IV. Conclusion
On a personal note. I have practiced as a civil defense attorney in Georgia for over 25 years, with well over 150 jury trials in venues throughout the state, some involving catastrophic injury, some death, and some routine soft-tissue injury cases, and I can speak from experience that the current environment is very different from the one I began those many years ago. I had not seen medical specials exceeding $100,000 even where there was a fusion surgery, and certainly not in cases where there was only physical therapy and perhaps some epidural injections. Now that is common-place. Jury verdicts very rarely reached seven figures, and $1,000,000 verdicts were reserved for death and serious disability. Now we see such verdicts regularly.
Despite these steady rises in medical specials and jury verdicts, meaningful tort reform packages this state has pushed forward have been struck down by our courts. Efforts at reform have become more modest over the years as the political pushback for such changes has increased by those with an interest to maintain the status quo.
Complicating matters is Georgia’s entirely untenable bad faith environment, based not upon great legal minds and strategy, but upon “I gotcha” law, where insurers are set up to miss almost absurd settlement conditions so that the insurer is then exposed to verdicts without regard to its policy limits. As it pertains to this paper, one simple way to force a policy limits settlement is to over-treat and over-charge, push the special damages to the policy limit, and then offer the insurer a few short days to offer up the policy limit, or else face the infinite liability that might result.
I have tried to offer some strategies for addressing these problems, but they are limited. The only true solution is in changing the system we have, which can only come from overhauling it and adopting the tort reform packages that a growing number of other states have. Until then, the various band-aids and rare scraps of hope we might find in an appellate opinion will not have much effect.
Footnotes & Citations:
[1] https://shorturl.at/kxDF6
[2]https://shorturl.at/wCH16
[3]https://shorturl.at/ELPTY
[4] Bowden v. Medical Center, 309 Ga. 188 (2020) at footnote 2.
[5] Id.
[6] https://shorturl.at/ejOQU
[7] See, for example, Fla. Stat. § 768.0427.
[8] This is typical lien agreement language from an actual provider agreed upon by the patient at the start of treatment.
[9] Yun-chien Chang, Theodore Eisenberg, Tsung Lee & Martin T. Wells, “Pain and Suffering Damages in Personal Injury Cases: An Empirical Study,” Coase-Sandor Working Paper Series in Law and Economics, No. 749 (2016).
[10] https://shorturl.at/cqsuR
Bodily Injury Claim Payments as a Function of Automobile Liability Insurance Limits
Stuart A. Klugman, Michael L. Murray. The Journal of Risk and Insurance, Vol. 51, No. 3 (Sep., 1984).
[11] It has also been shown that in states where the disclosure of policy limits is required, annual premiums are higher, arguably owed to increased payment of benefits in those states.
Insurance Coverage Disclosure Laws and Their Impact on Automobile Insurance Costs. Source: Journal of Insurance Regulation . Winter2006, Vol. 25 Issue 2, p53-70. 18p. Author(s): Hoyt, Robert E.; Lankau III, Charles A.
[12] A comprehensive list of those states not requiring the disclosure of liability limits: https://www.mwl-law.com/wp-content/uploads/2020/03/PRESUIT-DISCLOSURE-OF-LIABILITY-POLICY-LIMITS-IN-THIRD-PARTY-CLAIMS.pdf. Responses of certain states to phantom damages: http://www.talawfirm.com/several-states-take-action-to-exorcise-phantom-damages. See also, Florida Statute 768.0427.
[13] Evidence of collateral sources, meaning from sources other than the Defendant, particularly insurance benefits provided to the Plaintiff as the result of policies he has available to him, are generally not admissible into evidence for the jury’s consideration. Polito v. Holland, 258 Ga. 54, 55 (1988).
[14] Specifically, O.C.G.A. § 51-12-1(b), which was passed in 1987, permitted jurors to consider all collateral benefits received by an injured party in personal injury matters. That statute was struck down as unconstitutional in Denton v. Con-Way S. Express, Inc., 261 Ga. 41 (1991).
[15] https://www.judicialhellholes.org/hellhole/2022-2023/georgia/
[16] https://www.northwestgeorgianews.com/state/kemp-touts-tort-reform-as-2024-legislative-priority/article_c9b95883-3148-59d7-a2d6-277e92d4055d.html
[17] Arnold v. Liggins, 2023 WL 4246123
[18] Davis v. Pachuilo, 169 Ga. App. 677 (5) (1984).
[19] Stephens v. Castano-Castano, 346 Ga. App. 284, 291-292 (2018).
[20] Id at 289-291
[21] O.C.G.A. § 24-9-921.
[22] Bowden v. Medical Center, 297 Ga. 285 (2015) ( Bowden I) and Bowden v. Medical Center 309 Ga. 188 (2020) ( Bowden II).
[23] See, Paragraph I.A. above for a definition of “chargemaster.”
[24] Bowden I at 286.
[25] Polito v. Holland, 258 Ga. 54, 55 (1988), “The collateral source rule, stated simply, is that the receipt of benefits or mitigation of loss from sources other than the defendant will not operate to diminish the plaintiff’s recovery of damages.”
[26] Houston v. Publix Supermarkets, Inc. No. 1-13-CV-206-TWT, 2015 WL 4581541 (N.D. Ga. 7/29/15).
[27] Gaddy v. Terex Corp., 2017 WL 3473872 (N.D. Ga. 7/21/17).
[28] Compton v. Bach, 374 F. Supp. 3d 1296 (N.D. Ga. 2/28/19).
[29] Bowden II at 202.
[30] Relying upon the finding of Bowden v. Medical Center, 309 Ga. 188 (2020) where the Court found that providers received approximately 33% of the chargemaster rate.
[31] https://www.law.com/dailyreportonline/2023/08/08/jurys-80m-personal-injury-verdict-deemed-too-low-after-plaintiff-paralyzed/
[32] Southern General v. Holt, 262 Ga. 267 (1992).
[33] For example, https://www.rand.org/pubs/research_briefs/RB9768.html.
