ORTHO SPORT & SPINE PHYSICIANS, LLC v. JOHN ERNEST SNOWDEN

CourtCourt of Appeals of Georgia
DecidedJune 21, 2024
DocketA24A1047
StatusPublished

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Bluebook
ORTHO SPORT & SPINE PHYSICIANS, LLC v. JOHN ERNEST SNOWDEN, (Ga. Ct. App. 2024).

Opinion

FIRST DIVISION BARNES, P. J., GOBEIL and PIPKIN, JJ.

NOTICE: Motions for reconsideration must be physically received in our clerk’s office within ten days of the date of decision to be deemed timely filed. https://www.gaappeals.us/rules

June 21, 2024

In the Court of Appeals of Georgia A24A1046. MEDERNIX, LLC v. SNOWDEN et al. A24A1047. ORTHO SPORT & SPINE PHYSICIANS, LLC v. SNOWDEN et al.

BARNES, Presiding Judge.

In these companion appeals arising out of a discovery dispute in a personal

injury case, two non-parties, Ortho Sport & Spine Physicians, LLC (“Ortho Sport”)

and Medernix, LLC, challenge the trial court’s order compelling them to produce a

database report and other documents to the defendants (“Production Order”) and a

related protective order (“Protective Order”).1 For the reasons discussed below, we

conclude that the trial court abused its discretion in requiring Ortho Sport and

1 The discovery orders are directly appealable under the collateral order doctrine. See Benchmark Rehabilitation Partners v. SDJ Logistics, 367 Ga. App. 203, 204 (2) (885 SE2d 224) (2023). Medernix to create and produce a requested database report containing extensive

financial and billing information because the report was overly broad and was not

reasonably calculated to lead to admissible evidence. We therefore vacate the

Production Order and Protective Order to the extent that they required Ortho Sport

and Medernix to create and produce the database report and remand for further

proceedings consistent with this opinion.

The record reflects that Glenda Ochoa sued John Ernest Snowden, New South

Trucking, LLC, LAD Truck Lines, Inc., and Protective Insurance Company in the

Superior Court of Oconee County for damages arising from an automobile accident.2

As part of her damages, Ochoa sought to recover her past and future medical

expenses, and she relied on medical treatment and bills she received from different

providers, including Ortho Sport. Ortho Sport is an orthopedic medical practice with

locations in several states. Ortho Sport provided medical treatment to Ochoa pursuant

to a “letter of protection,” a contractual arrangement under which a patient is

permitted to undergo treatment and defer payment to a later date. Under such a

2 In addressing the factual and procedural history of these companion appeals, we have taken into account both appellate records. See Sentinel Offender Svcs. v. Glover, 296 Ga. 315, 321, n. 13 (766 SE2d 456) (2014) (explaining that reviewing courts may take judicial notice of the records in companion appeals). 2 contract, the patient’s outstanding medical debt is collateralized by any potential claim

arising from the alleged injuries and is secured by a medical lien, but the patient

remains personally liable for the balance. See generally OCGA § 44-14-470 et seq.

(setting out the statutory framework for medical liens). Ochoa’s medical bills for

treatment she received from Ortho Sport exceeded $18,000.

During the course of the litigation, the defendants served Ortho Sport and its

claims manager, Medernix, with almost identical requests for production of records

and database materials. Pertinent to those requests, Ortho Sport and Medernix

utilized two software databases: eClinicalWorks, which was a medical billing and

records software program, and Salesforce, which included information about any law

firm associated with a patient. Among other materials, the defendants sought (1)

communications between Ortho Sport, Ochoa’s attorneys, and any litigation funding

companies involved in the case, including communications logged into eClinicalWorks

and/or Salesforce; (2) all applicable contracts between Ortho Sport, Ochoa, Ochoa’s

attorneys, and any litigation funding companies involved in the case; (3) “HIPAA

audit logs”3 reflecting who had accessed Ochoa’s medical files and any changes made

3 “HIPAA” refers to the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191. 3 to those files; and (4) a database report revealing Ortho Sport/Medernix’s billed

charges or rates, as well as any adjustments made to those rates charges or rates,

“categorized by associated law firm referral partner.” Additionally, the defendants

requested that Ortho Sport/Medernix generate eClinicalWorks Report 37.08,

“Financial Analysis at CPT Level (With Everything),” which was a spreadsheet that

would list, for every Ortho Sport patient, the amount billed for each visit or procedure

at every Ortho Sport location, categorized by CPT code;4 the amount written-off,

adjusted, or accepted in satisfaction for each such bill; the payor of each bill; and

information about who referred each patient to Ortho Sport (the “Database Report”

or “Report”). The defendants requested that the Database Report include

information for the past three years, and further advised that all “HIPAA-protected

personal identifying information,” such as patient names and addresses, could be

redacted.

4 “CPT” code stands for Current Procedural Terminology codes. CPT codes are a national uniform coding structure created for use in billing and overseen by the American Medical Association. They are used by all health insurance companies and by Medicare and Medicaid. A code represents at least two things: the procedure or service performed and the level of complexity involved in it. United States v. Moss, 34 F4th 1176, 1181-1182 (I) (A) (11th Cir. 2022). 4 When Ortho Sport and Medernix did not produce all of the requested materials,

including the Database Report, the defendants filed a motion to compel their

production. Among other things, the defendants argued that the Database Report was

discoverable because it would reveal data pertaining to the reasonableness and

necessity of Ortho Sport / Medernix’s medical bills issued for the treatment of Ochoa,

and would reveal data pertaining to the scope of Ortho Sport’s relationship with

personal injury law firms generally and Ochoa’s attorneys in particular, which would

be relevant to issues of bias, intent, and motive. In connection with their motion to

compel, the defendants submitted the affidavit of an expert in the eClinicalWorks

software program, who provided instructions on how to generate the Database Report.

The defendants specified that the names of any patients and other personal identifying

information should be redacted from the Database Report, and the instructions

provided by the software program expert explained how to generate a report with that

information blacked out.

Additionally, the defendants submitted a sealed letter brief and two sealed

exhibits to the trial court in chambers as part of their motion to compel.5 The sealed

5 The trial court subsequently entered an order providing that the exhibits would remain under seal but would be made part of the record. 5 exhibits were attorney referral ledgers created by clinics that allegedly were analogous

to Ortho Sport, and which the defendants argued could serve as exemplars for the type

of information they were seeking to have produced in the present case. The

defendants further argued that the sealed ledgers showed that Ochoa’s attorneys had

extensive referral relationships with other, similar Atlanta orthopedic clinics.

Ortho Sport filed a response in opposition to the motion to compel and a

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ORTHO SPORT & SPINE PHYSICIANS, LLC v. JOHN ERNEST SNOWDEN, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ortho-sport-spine-physicians-llc-v-john-ernest-snowden-gactapp-2024.