Silver Hill Hospital, Inc. v. Kessler

200 Conn. App. 742
CourtConnecticut Appellate Court
DecidedOctober 13, 2020
DocketAC42545
StatusPublished
Cited by3 cases

This text of 200 Conn. App. 742 (Silver Hill Hospital, Inc. v. Kessler) is published on Counsel Stack Legal Research, covering Connecticut Appellate Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Silver Hill Hospital, Inc. v. Kessler, 200 Conn. App. 742 (Colo. Ct. App. 2020).

Opinion

*********************************************** The “officially released” date that appears near the be- ginning of each opinion is the date the opinion will be pub- lished in the Connecticut Law Journal or the date it was released as a slip opinion. The operative date for the be- ginning of all time periods for filing postopinion motions and petitions for certification is the “officially released” date appearing in the opinion.

All opinions are subject to modification and technical correction prior to official publication in the Connecticut Reports and Connecticut Appellate Reports. In the event of discrepancies between the advance release version of an opinion and the latest version appearing in the Connecticut Law Journal and subsequently in the Connecticut Reports or Connecticut Appellate Reports, the latest version is to be considered authoritative.

The syllabus and procedural history accompanying the opinion as it appears in the Connecticut Law Journal and bound volumes of official reports are copyrighted by the Secretary of the State, State of Connecticut, and may not be reproduced and distributed without the express written permission of the Commission on Official Legal Publica- tions, Judicial Branch, State of Connecticut. *********************************************** SILVER HILL HOSPITAL, INC. v. DAWN KESSLER (AC 42545) Alvord, Elgo and Pellegrino, Js.

Syllabus

The plaintiff hospital sought to recover damages in connection with unpaid medical services that it provided to the defendant. The hospital billed Medicare for payment, which initially paid the entire balance. Subse- quently, Medicare rescinded coverage for a portion of the services after discovering that the defendant had workers’ compensation coverage for a portion of those medical expenses. The hospital informed the defen- dant of this development and asked the defendant to contact Medicare to resolve the coverage dispute. The defendant refused to contact Medi- care and did not submit payment for the remaining balance to the hospital. Thereafter, the matter was referred to an attorney fact finder, who issued his report, finding that the defendant owed a balance to the plaintiff and that the defendant failed to prove her special defense of non compos mentis. The trial court overruled the defendant’s objection to the fact finder’s report and rendered judgment for the plaintiff. On appeal, the defendant claimed, inter alia, that the fact finder’s conclu- sions were not based on evidence presented at trial. Held: 1. The defendant’s claim that the fact finder’s conclusions were not based on evidence presented at trial was unavailing, as there was adequate support in the record for the findings of fact reached by the fact finder; the record contained sufficient evidence for the fact finder to conclude that the plaintiff provided medical services to the defendant, that the defendant owed a balance for the services rendered, and that the defen- dant had not paid the balance and, therefore, the fact finder’s findings were based on evidence presented at trial and were consistent with the applicable rule of practice (§ 19-8). 2. The defendant’s claim that the fact finder improperly failed to consider her contention that the plaintiff had a duty to contact Medicare to resolve the coverage issue was unavailing, as the defendant’s pleadings did not provide a legal framework from which the fact finder could properly assess whether it was the plaintiff’s duty to resolve the coordination of benefits issues; the failure to perform a contractual or legal duty must be alleged as a special defense, and as there was no such special defense properly before the fact finder, the fact finder had no obligation to consider evidence not relevant to the legal issues before it. 3. The trial court properly denied the defendant’s objections to the fact finder’s report, as there were sufficient subordinate facts contained in the record for the fact finder’s recommendations, and there was no legal framework for the fact finder or the trial court to determine whether the plaintiff failed to perform a contractual or legal duty; the fact finder was not required to determine whether the plaintiff had a duty to dispute Medicare’s claim that its liability was secondary, and the trial court appropriately declined to do so as well. 4. This court declined to review the defendant’s claim that a certain hospital debt collection statute (§ 19a-673d) compelled judgment in favor of the defendant, as the record revealed that § 19a-673d did not appear in the operative pleadings; although the defendant originally pleaded a different statute (§ 19a-673) concerning collections by hospitals from uninsured patients as a special defense, that special defense was ulti- mately stricken, the defense was not repleaded, and it was not distinctly raised before the fact finder. Argued May 15—officially released October 13, 2020

Procedural History

Action to recover damages for unpaid medical ser- vices, and for other relief, brought to the Superior Court in the judicial district of Stamford-Norwalk, where the matter was referred to Joseph DaSilva, attorney fact finder, who filed a report recommending judgment for the plaintiff; thereafter, the court, Hon. A. William Mot- tolese, judge trial referee, overruled the defendant’s objection to the acceptance of the report and rendered judgment in accordance with the fact finder’s report, from which the defendant appealed to this court. Affirmed. James T. Baldwin, for the appellant (defendant). Patrick M. Fahey, with whom, on the brief, was Michael G. Chase, for the appellee (plaintiff). Opinion

ELGO, J. The defendant, Dawn Kessler, appeals from the judgment of the trial court, rendered following a trial before an attorney fact finder, in favor of the plain- tiff, Silver Hill Hospital, Inc., on the plaintiff’s complaint in the amount of $17,087.15. On appeal, the defendant claims that (1) the fact finder’s conclusions were not based on evidence presented at trial, (2) the fact finder failed to consider the issue of whether the plaintiff was responsible for resolving a coverage dispute issue with Medicare, (3) the court improperly denied her objec- tions to the fact finder’s report, and (4) General Statutes § 19a-673d operates as a statutory bar to the plaintiff’s debt collection action. We affirm the judgment of the trial court. This case concerns a dispute over payment for medi- cal services. The record reflects, and the parties do not dispute, that the plaintiff provided inpatient and outpatient services to the defendant from April 22 to June 6, 2014. The plaintiff’s charges for those services totaled $59,291.50. The plaintiff billed Medicare,1 which initially paid the entire sum. Medicare subsequently informed the plaintiff that, according to its records, the defendant had workers’ compensation coverage for a portion of those medical expenses. On November 2, 2016, Medicare rescinded coverage for certain services and the plaintiff thereafter returned $17,087.15 to Medicare. The defendant, as well as her son and her daughter- in-law, were informed of this development and were asked to contact Medicare to resolve the coverage dis- pute. The plaintiff’s witness, Shakia Whitehurst, senior financial counselor for the plaintiff, testified at trial that the defendant refused to contact Medicare to resolve the coordination of benefits issue. In her testimony, the defendant acknowledged that she had not submitted any payment to the plaintiff.2 On May 1, 2017, the plaintiff commenced the underly- ing action to collect unpaid expenses for services pro- vided to the defendant. In its complaint, the plaintiff alleged that it furnished medical services to the defen- dant from April 22 to June 5, 2014, and that the plaintiff submitted bills to the defendant totaling $59,291.50. By way of relief, the plaintiff sought the unpaid balance of $17,087.15.

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Bluebook (online)
200 Conn. App. 742, Counsel Stack Legal Research, https://law.counselstack.com/opinion/silver-hill-hospital-inc-v-kessler-connappct-2020.