State Court Refuses to Reduce Plaintiff's Economic Damages Award Due to Medicare's Subrogati


William Ashmore presented to Hartford Hospital for a non-emergency, planned procedure. It was during his hospital stay that he passed away as a result of the alleged negligence of the employees of the hospital. Suit was brought against the hospital by Mr. Ashmore’s estate and $75,000 in economic damages were awarded following a jury trial. The damages represented the amount billed to William Ashmore by Hartford Hospital (Defendant) for the hospital stay during which he passed away. The jury found that his passing was a result of the Defendant’s negligent care.

William Ashmore was a Medicare beneficiary at the time of his hospital stay and the cost of the stay was paid by a Medicare plan. However, at the time of the present case, Medicare had not yet indicated an intention to seek reimbursement for the payments made. For this reason, the Defendant argued that the amount of damages should be reduced pursuant to a state law rule which accounts for collateral sources. However, the Plaintiff argues that Medicare has a right of subrogation as a matter of law and, as a result, the state law rule would not apply.

In reviewing the state law as well as the Medicare Secondary Payer Act (MSP), the Superior Court of Connecticut notes that it is not surprising that Medicare has not yet asserted a lien given that the procedure for which negligent care was provided was a planned procedure. However, the Court notes that upon receipt of this primary payment by the hospital, the Plaintiff is now subject to any liability to Medicare which may arise as a result of the payment. The Court held that its state law rule is not contingent upon the holder of a subrogation right asserting that right and denied the Defendant’s motion to reduce the damages based upon collateral sources.

#Subrogation #Medicare #Connecticut #MedicareSecondaryPayer

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