United States District Court, M.D. Louisiana
RULING AND ORDER
A. JACKSON, CHIEF JUDGE UNITED STATES DISTRICT COURT
the Court is the Motion in Limine to Exclude
Evidence of Total Amount Billed for Medical Expenses (Doc.
27) filed by Defendants Pinnacle Entertainment, Inc. of
Delaware ("Pinnacle") and PNK (Baton Rouge)
Partners ("PNK"). Plaintiff filed an opposition.
(Doc. 42). Invoking principles of the collateral source rule
under Louisiana law, Defendants' Motion seeks to exclude
the total amount that Plaintiff was billed for Medical
Expenses on the ground that it is irrelevant. (Doc. 42 at p.
3). Plaintiff argues that the totals are relevant to the
issue of damages. (Doc. 53 at p. 5). For reasons explained
fully herein, the Motion is DENIED.
alleges that on or about October 20, 2014, she was a patron
at L'Auberge Casino & Hotel, owned and operated by
Pinnacle and PNK. (Doc. 1-3 at pp. 1-2). While in front of a
slot machine, the chair she was sitting in collapsed, causing
serious injury. (Id.). She brought suit against
several parties, including Pinnacle and PNK. (Id. at
to this motion, Plaintiff utilized the service of Bayou
Medical Management ("BMM") to pay for her medical
expenses after the incident. (Doc. 42). BMM contracts with
personal injury plaintiffs. (Doc. 27-1 at p. 2). BMM agrees
to pay the costs of medical care for the personal injury
plaintiffs up front. (Doc. 42 at p. 2). Further, the personal
injury plaintiffs payment to BMM is deferred until
settlement, up to 2 years, but the plaintiff must pay the
"full and customary" amount, meaning the full
amount for the service prior to any discounts that BMM might
negotiate for the service. (Doc. 27-1 at p. 2; Doc. 27-2 at
p. 1; Doc. 42 at p. 2)
makes a profit from this contract by negotiating with the
medical providers to receive discounts on what it pays for
the medical services. (Doc. 42 at p. 3). While BMM will
ultimately be paid by the plaintiff the "full and
customary" fee, BMM pays a lower amount at a discount it
receives from the medical provider. (Id.; Doc. 27-1
at p. 2). BMM makes a profit by contracting with personal
injury plaintiffs and charging them the full rate for the
medical services, but it only pays the discounted rate. In
exchange, personal injury plaintiffs have their medical costs
paid upfront and prior to the litigation.
argues that total costs of the medical bills to Plaintiff are
irrelevant, because BMM receives a discount on paying for the
medical services. (Doc. 27-1 at pp. 2-3). In support of this
point, citing Hoffman v. 21st Century North America
Insurance Company, Defendants point to the exclusions from
the collateral source rule under Louisiana law and argue that
without the benefits of the collateral source rule, the
amount that Plaintiff pays to BMM is not relevant-all that
matters is the amount actually paid to the physicians that
treated Plaintiff. (Id. at 3). In other words,
Defendants argue that if the expenses are not recognized
under the collateral source rule, then the total amount must
responds by arguing that the costs Plaintiff actually pays
for her medical expenses are relevant to the amount of
damages, and that Hoffman is distinguishable. (Doc.
42 at pp. 3-4).
adopted by the Louisiana Supreme Court, the collateral source
rule is a rule of evidence and damages." Kadlec Med.
Ctr. v. Lakeview Anesthesia Associates, 527 F.3d 412,
425 (5th Cir. 2008). The rule prevents a tortfeasor from
benefiting if the plaintiff received payment from sources
independent of the tortfeasor. Bozeman v. State,
2003-1016 (La. 7/2/04), 879 So.2d 692, 698. The rationale
behind this rule is that a tortfeasor should not benefit-by
claiming damages should be reduced- because of outside
benefits provided to the plaintiff or procured by the
plaintiff. Id. Otherwise, Plaintiffs may not be
fully compensated for their injury. The rule allows a
Plaintiff to present the full value of treatment, because
barring the total would necessarily inure to the benefit of
the accused tortfeasor.
the crux of Defendant's argument rests on an exclusion
explained in Hoffman. In that case, the Louisiana
Supreme Court held that a Plaintiff could not seek recovery
for the full costs of the medical expenses incurred because
Plaintiffs attorney had negotiated a discount with the
medical provider. Hoffman, 2015 WL 5776131 at *4.
The Louisiana Supreme Court recognized that "allowing
the plaintiff to recover an amount for which he has not paid,
and for which he has no obligation to pay, is at cross
purposes with the basic principles of tort recovery."
Id. at *4. Thus, the Court recognized an exception
to the collateral source rule when attorneys negotiate a
discount for their clients and the total amount the
client has to pay is reduced.
the Court is not persuaded that this case falls under the
exception, and thus, Plaintiff may present evidence of the
total costs she actually must pay. In Hoffman the
Louisiana Supreme Court was presented with a plaintiff who
was attempting to recover money above the amount the
plaintiff actually paid for medical expenses. However, in
this case, the cost that Plaintiff will actually incur for
her medical expenses is the customary rate that the doctors
charge. (Doc. 42 at p. 2). And while BMM received a discount
upfront, at most, this difference between the customary
cost-which plaintiff has to pay in full-and the discounted
rate consists of the profit BMM receives for agreeing to
finance the medical costs up-front. (Id. at 3).
that Plaintiff will have to pay the customary costs of her
medical care, she will be allowed to present to the jury the
cost that she will incur as a result of her injury.