Med. Ctr., Inc. v. Bowden, A14A0266.

• Decision Date: 24 June 2014
• Docket Number: No. A14A0266.,A14A0266.
• Citation: 327 Ga.App. 714,761 S.E.2d 116
• Court: Georgia Court of Appeals
• Parties: The MEDICAL CENTER, INC. v. BOWDEN.

327 Ga.App. 714

761 S.E.2d 116

The MEDICAL CENTER, INC.

v.BOWDEN.

No. A14A0266.

Court of Appeals of Georgia.

June 24, 2014.

Bobby Lee Scott, for Appellant.

Charles A. Gower, Columbus, for Appellee.

MILLER, Judge.

The Medical Center, Inc. (“TMC”) filed a hospital lien to recover the costs of providing emergency medical treatment to Danielle Bowden, an uninsured patient, for injuries she sustained in an automobile accident. When a dispute arose regarding satisfaction of the lien from insurance proceeds, the insurance company filed an interpleader action. Bowden counterclaimed against TMC, alleging that the hospital's charges were unreasonable because it overcharges uninsured patients. Bowden subsequently moved to compel TMC to produce its pricing agreements with health insurance companies and other information related to its charges of insured and uninsured patients. The trial court granted Bowden's motion to compel and issued a certificate of immediate review. We granted TMC's application for interlocutory review, and on appeal TMC contends that the ordered discovery is not relevant nor reasonably calculated to lead to admissible evidence and encompasses confidential and proprietary information. This Court finds that the discovery Bowden seeks is not relevant to her claim that TMC's medical charges for her treatment were unreasonable and we reverse the trial court's order.

We review a trial court's ruling on a motion to compel discovery for an abuse of discretion. Lovell v. Ga. Trust Bank, 318 Ga.App. 860, 862(1), 734 S.E.2d 847 (2012).

On July 1, 2011, Bowden was injured when a rental car in which she was a passenger was involved in an accident. Bowden was taken by ambulance to TMC in Columbus, where she received emergency medical treatment, including surgery, and was hospitalized for three days. The next day, Bowden's mother signed a consent for treatment and a payment policy acknowledgment.¹ Bowden, who had no health insurance at the time of the accident, was discharged on July 4, 2011. On July 13, Bowden returned to the hospital for physical therapy and signed an admission form obligating her to pay for the therapy. TMC billed Bowden approximately $21,500 for her treatment, which included emergency surgery, two CT scans, and physical therapy over the three days that she was hospitalized. TMC filed a hospital lien (OGCA § 44–14–470 et seq.) to recover the costs of Bowden's care.

Enterprise Rentals owned the vehicle involved in the accident and insured it under a policy with a limit of $25,000. Negotiations ensued between Bowden, TMC, and Enterprise. The hospital offered to settle its $21,500 lien for $8,333, but Bowden refused and no settlement could be reached. Enterprise then filed an interpleader action and paid $25,000 into the registry of the court. Bowden cross-claimed against TMC, alleging that the hospital's charges were unreasonable and excessive because she was charged more than an insured patient, there was no valid contract between her and TMC, any contract was void due to unconscionability, TMC had engaged in deceptive trade practices, and TMC would be unjustly enriched if it collected the full amount.

To support her claim that TMC's charges are not reasonable, Bowden propounded discovery seeking TMC's pricing agreements with insurance companies and information about TMC's revenue and the number of uninsured patients it treats. TMC objected to Bowden's discovery requests on relevance and confidentiality grounds, and Bowden filed a motion to compel. Following a hearing, the trial court granted Bowden's motion, ruling that TMC had to provide the information subject to a protective order.

TMC contends that the discovery Bowden seeks is not relevant to her claim nor reasonably calculated to lead to admissible evidence and therefore the trial court erred in granting Bowden's motion to compel. We agree.

Parties may obtain discovery regarding any matter, not privileged, which is relevant to the subject matter involved in the pending action, whether it relates to the claim or defense of the party seeking discovery or to the claim or defense of any other party.... It is not ground for objection that the information sought will be inadmissible at the trial if the information sought appears reasonably calculated to lead to the discovery of admissible evidence.

OGCA § 9–11–26(b)(1). “While the extent of discovery is generally within the discretion of the trial court judge, this discretion must be based on sound legal analysis with an eye to promoting the purpose of discovery and limiting its abuse.” (Citation and footnote omitted.) Intl. Harvester Co. v. Cunningham, 245 Ga.App. 736, 739(1), 538 S.E.2d 82 (2000).

With this principle in mind, we look to the purpose of the hospital lien statute, which provides that a hospital operating in this state “shall have a lien for the reasonable charges for hospital ... care and treatment of an injured person[.]” OCGA § 44–14–470(b). “The [hospital lien] statute enables hospitals to collect payment for unpaid reasonable charges for furnishing hospital care to an injured person by giving the hospital a lien against any cause of action that accrues to the injured person arising out of the injuries that necessitated the care.” MCG Health, Inc. v. Kight, 325 Ga.App. 349, 351(1), 750 S.E.2d 813 (2013). In short, the lien allows the hospital to step into the shoes of the injured person for purposes of receiving payment from the tortfeasor or the tortfeasor's insurance company for economic damages represented by the hospital bill. Id. Moreover, the hospital lien statute allows hospitals to collect the full amount of their bills, regardless of insurance “write-offs.” Id.

In her discovery requests, Bowden sought (1) specific, itemized bills of what she would have been charged had she been covered by Medicaid, Medicare, Blue Cross/Blue Shield of Georgia, Tri-care, or TMC's indigent patient program; (2) total gross revenue received by TMC during the fiscal year prior to July 2011 where full rates were charged pursuant to OCGA § 31–7–11; ² (3) TOTAL revenuesRECEIVED BY Tmc during the fiscal year prior to July 2011 where the rates charged were less than full rates set forth in OCGA § 31–7–11; (4) the percentage of patients in fiscal years 2010 and 2011 that paid the full rates; (5) the percentage of patients in fiscal years 2010 and 2011 that paid less than the full rates; (6) the number of uninsured patients treated in TMC's emergency room since July 1, 2011; (7) the number of uninsured patients seen in the emergency room since July 1, 2011 and billed for treatment; (8) rate-setting agreements from the years 2010, 2011, and 2012 between TMC and Medicaid, Medicare, Blue Cross/Blue Shield of Georgia, Tri-care, and the indigent patient program; and (9) any admission form used during the previous six years, and the dates the form was used.

At issue in this case is whether TMC's charges to Bowden were reasonable. Pursuant to OCGA § 31–7–11, hospitals must provide information regarding their charges to consumers upon request, and during the course of litigation, Bowden requested and received this information from TMC.

The discovery that Bowden seeks regarding rate-setting agreements and what Bowden would have been billed under those agreements is not relevant to the issue of whether TMC's bills for her medical care are reasonable....