New Post Howell Case
Uspenskayta v. Meline, 2015 WL 6510915, 14 C.D.O.S. 11834  (October 29, 2015).
         The Third Appellate district has just held that the amount a factoring company pays to purchase a lien from a medical provider is not determinative on the question of the reasonable value of medical treatment.  Where the claimant is uninsured and obtains medical services on a lien, the medical provider may sell its account to a third party.   According to the Court in Uspenskaya v. Meline the lienholder makes a decision to purchase the lien based on the merits of the claim.  Thus, when a medical provider sells its account to a third party, the purchase price is based on the collectability of the debt and not a reasonable approximation of the value of the plaintiff's medical expenses.  Without more,  "the probative value of that evidence as to the reasonable value [is] minimal."   However, the amount the third party paid would be admissible if there was "some additional evidence showing a nexus between the amount paid . . . and the reasonable value of the medical services."
            The Court's said,
            Plaintiff lacked medical insurance and contracted with her medical providers to treat her in exchange for a lien on whatever she might recover from defendant in this lawsuit. A third party assignee, MedFin Managers, LLC (MedFin), purchased the lien from the medical providers for a discounted amount. Plaintiff remained liable on the total bill. Defendant contends that the trial court erred in denying her motion to admit evidence of the amounts MedFin paid to purchase the right to recover the full amounts plaintiff's medical providers billed plaintiff. Defendant argues that the trial court should have allowed her to introduce evidence of the amounts MedFin paid to the medical providers (the MedFin payments) as evidence of the reasonable cost of treatment provided plaintiff, particularly since the court denied defendant's motion to exclude evidence of the billed amounts.
            [W]e conclude that because defendant proffered no evidence to show that the MedFin payments represented the reasonable value of plaintiff's treatment, the probative value of that evidence was substantially outweighed by the probability that it would create a substantial danger of undue prejudice as well as a danger of confusing and misleading the jury. 
            Critical to the Court's decision and the factor distinguishing it from Howell, is that the injured party remained liable for the bill.
            However, the Court made clear that,
[T]he inquiry into reasonable value for the medical services provided to an uninsured plaintiff is not necessarily limited to the billed amounts where a defendant seeks to introduce evidence that a lesser payment has been made to the provider by a factor such as MedFin. In such cases, the inquiry requires some additional evidence showing a nexus between the amount paid by the factor and the reasonable value of the medical services. As the trial court observed, such evidence was not offered here. (Emphasis added.)

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