Bowden v. the Medical Center, Inc.

Procedural entryThis page is a short order in Bowden v. the Medical Center, Inc.. Read the opinion of the Court — 297 Ga. 285
Supreme Court of Georgia·Decided June 15, 2015·No. S14G1632·Published

Opinion

297 Ga. 285 FINAL COPY

S14G1632. BOWDEN v. THE MEDICAL CENTER, INC.

NAHMIAS, Justice.

Georgia law gives a hospital a lien for the reasonable charges for its care and treatment of an injured person against all causes of action accruing to that person on account of her injuries, and establishes a process for the hospital to perfect its lien for the amount claimed to be due. See OCGA §§ 44-14-470, 44- 14-471. The Medical Center, Inc. (TMC) provided hospital care to Danielle Bowden, who did not have health insurance, after she was injured in a car wreck, billed her $21,409.59 for her care, and filed a hospital lien for that amount. In a subsequent lawsuit, Bowden sought to invalidate the lien on the ground that the billed charges were grossly excessive and did not reflect the reasonable value of the care she received, while TMC alleged that $21,409.59 was a reasonable amount for Bowden’s care and sought a declaratory judgment establishing the validity of its lien.

During discovery, TMC objected to Bowden’s requests for, among other things, information and documents regarding the amounts that the hospital charged insured patients for the same type of care. Bowden filed a motion to

compel discovery, which the trial court granted subject to the entry of a protective order to ensure confidentiality. On interlocutory appeal, the Court of Appeals reversed, holding that the trial court abused its discretion in granting the motion because “the discovery Bowden seeks is not relevant to her claim that TMC’s medical charges for her treatment were unreasonable.” The Medical Center, Inc. v. Bowden, 327 Ga. App. 714, 714 (761 SE2d 116) (2014). We granted Bowden’s petition for certiorari to review that holding.

As explained below, 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. The Court of Appeals erred in concluding otherwise and in holding on that ground that the trial court abused its discretion in granting Bowden’s motion to compel. Accordingly, we reverse the Court of Appeals’ judgment.

1. On July 1, 2011, the rental car in which Danielle Bowden was a passenger was involved in an accident. At about 10:40 p.m., Bowden, who was 21 years old and did not have health insurance, was taken by ambulance to TMC’s hospital in Columbus, Georgia, where she received emergency medical

treatment that included surgery for a broken leg. At some point on July 2, Bowden’s mother allegedly signed an admission form that said in relevant part:

I, the undersigned, am seeking treatment at The Medical Center, Inc. . . . for myself or a person for whom I am responsible for his/her medical care. . . . The undersigned agrees, whether as Agent, Guarantor, or Patient, that in consideration of the services to be rendered to the patient, the undersigned is individually obligated to pay the account in full of the Hospital, and attending physicians, or organizations, or other satisfactory financial arrangements must be made prior to time of patient discharge.

Bowden was discharged from the hospital on July 4. On July 13, she returned to the hospital for physical therapy and allegedly signed the same admission form herself. TMC billed Bowden a total of $21,409.59 for her care and filed a hospital lien for that amount pursuant to OCGA § 44-14-470 (b).1

1 OCGA § 44-14-470 (b) says:

Any person, firm, hospital authority, or corporation operating a hospital, nursing home, or physician practice or providing traumatic burn care medical practice in this state shall have a lien for the reasonable charges for hospital, nursing home, physician practice, or traumatic burn care medical practice care and treatment of an injured person, which lien shall be upon any and all causes of action accruing to the person to whom the care was furnished or to the legal representative of such person on account of injuries giving rise to the causes of action and which necessitated the hospital, nursing home, physician practice, or provider of traumatic burn care medical practice care, subject, however, to any attorney’s lien. The lien provided for in this subsection is only a lien against such causes of action and shall not be a lien against such injured person, such legal representative, or any other property or assets of such persons and shall not be evidence of such person’s failure to pay a debt. This subsection shall not be construed to interfere with the exemption from this part provided by Code Section 44-14-474 [exempting moneys that become due under the workers’ compensation statutes].

On July 27, 2012, the rental car company (Enterprise) filed a complaint in interpleader against Bowden and TMC and paid $25,000 into the registry of the trial court. The complaint alleged that Enterprise was self-insured with an insurance certificate that provided automobile coverage up to $25,000; that Bowden presented a claim against Enterprise, which Enterprise offered to settle for the policy limit; and that the offer was rejected because Bowden and TMC were unable to agree on how much of the settlement proceeds should go to TMC to release its hospital lien.2 On August 20, 2012, Bowden answered the complaint and filed a crossclaim against TMC, alleging that she was uninsured and indigent at the time of her treatment and that her bill of $21,409.59 was grossly excessive and did not reflect the reasonable value in the community of her treatment. Bowden also alleged that the emergency nature of her injuries and treatment prevented her from utilizing the provisions of OCGA § 31-7-11 to make pre-treatment cost comparisons.3 She denied signing a payment contract with TMC and alleged

2 TMC had offered to settle its lien for $8,333, but Bowden declined.

3 OCGA § 31-7-11 says:

(a) Any hospital shall, upon request, provide a written summary of certain hospital and related services charges, including but not limited to:

that any such contract would be void as both procedurally and substantively unconscionable. Bowden asserted a claim against TMC for unjust enrichment and, alternatively, breach of contract and violation of Georgia’s version of the Uniform Deceptive Trade Practices Act (“UDTPA”), OCGA §§ 10-1-370 to 10- 1-375. As relief, she sought damages and attorney fees and asked that TMC’s “lien be dismissed.”

(1) The average total charges per patient day for the facility’s previous fiscal year;

(2) The daily rate for a room in said hospital, which rate shall include an explanation of the categories of services included in said charge;

(3) Anesthesia charges, with an explanation of the categories of services included in this charge;

(4) Operating room charges;

(5) Recovery room charges;

(6) Intravenous administration charges;

(7) Emergency room charges, with an explanation of the categories of services included in the charge;

(8) The charge for the patient care kit or admission kit or other such items furnished to the patient on admission;

(9) Charges for specific routine tests, including but not limited to a complete blood count, urinalysis, and chest X-ray; and (10) Charges for specific special tests, including but not limited to electrocardiogram, electroencephalogram, CAT scan of the head, CAT scan of liver, CAT scan of lungs, CAT scan of skeletal system, spirometry, and complete pulmonary function.

Such written summary of charges shall be composed in a simple clear fashion so as to enable consumers to compare hospital charges and make cost-effective decisions in the purchase of hospital services.

(b) The [Department of Community Health] shall adopt rules and regulations to implement the provisions of this Code section and shall implement such regulations as provided in Code Section 31-7-2.1.

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