Temesvary v. Houdek

703 N.E.2d 613, 301 Ill. App. 3d 560, 234 Ill. Dec. 752, 1998 Ill. App. LEXIS 806
CourtAppellate Court of Illinois
DecidedNovember 24, 1998
Docket2-98-0109
StatusPublished
Cited by11 cases

This text of 703 N.E.2d 613 (Temesvary v. Houdek) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Temesvary v. Houdek, 703 N.E.2d 613, 301 Ill. App. 3d 560, 234 Ill. Dec. 752, 1998 Ill. App. LEXIS 806 (Ill. Ct. App. 1998).

Opinion

JUSTICE RATHJE

delivered the opinion of the court:

In this appeal, we are asked to decide if a trial court may determine the reasonableness of a physician’s charges prior to adjudicating the physician’s lien under the Physicians Lien Act (the Act) (770 ILCS 80/ 0.01 et seq. (West 1996)). We answer the question in the affirmative but reverse and remand on other grounds.

The plaintiff, Doris Temesvary, filed a personal injury lawsuit against the defendant, Diane Houdek. On November 10, 1997, the plaintiff filed a petition to adjudicate liens, alleging a settlement of the above suit and that the only outstanding lien was the bill of Dr. A.G. Phillips, in the amount of $8,140 for nuclear medicine studies performed on the plaintiff. The petition further alleged that Dr. Phillips’s charges were “in excess of the normal and customary costs for such services in the medical community” and were therefore “unreasonable.” Dr. Phillips filed a response, and the matter was set for hearing on December 23, 1997.

Prior to the commencement of the hearing, Dr. Phillips disputed the authority of the trial court to refuse to enforce the amount of his lien when the lien was not in excess of one-third of the amount of the settlement. See 770 ILCS 80/1 (West 1996). The trial court rejected that argument, relying on the “reasonable charges” language of the Act (770 ILCS 80/1 (West 1996)).

Dr. Phillips, whose office is in Naperville, testified that he specializes but is not board certified in nuclear medicine. He provides nuclear medicine imaging services, mostly to patients who have been injured in accidents and who are referred to him by other healthcare providers. He is not associated with any hospital or group practice. When a patient is referred to him, he takes a history, explains what tests will be performed, and how much it will cost. He has the patient sign forms indicating that the patient has had a complete explanation of the procedure. The doctor then administers a radioactive isotope; after a waiting period, the nuclear medicine studies are performed. Imaging is done with a gamma system, which provides images of the target organ system; the modalities used with the system are planar, digital, and SPECT. After the processing and interpretation, a report is sent to the referring physician. In setting his fees, Dr. Phillips takes into consideration his overhead, which includes the cost of his equipment, maintenance expenses, and office costs.

Dr. Phillips testified further that the plaintiff was referred to him by another physician. Upon meeting with the plaintiff, Dr. Phillips explained the procedures and the costs involved for each type of study he would perform. The plaintiff signed a request and consent for a nuclear medicine study. She also signed a fee and price disclosure, which stated that she understood that the price for the nuclear studies would range from $1,500 to $9,500 and that the price was higher than what was charged at local hospitals.

Dr. Phillips further testified that the plaintiff was at his office from 9:30 a.m. to 3 p.m for the performance of the nuclear studies. She was the only patient seen that day. After the studies were performed, the doctor processed the work, interpreted the results, and dictated the report. All together, he spent approximately eight hours on the plaintiffs case performing the above tasks. He believed that his charges were reasonable.

Dr. Phillips further testified that nuclear medicine studies can be performed at hospitals where the charges are considerably less. His practice differs from that of a hospital in that, in addition to providing services to the patients, he is responsible for all of the equipment and maintenance costs and for running the business and collecting payments. In a hospital, a technician actually performs the nuclear studies, not a physician. The SPECT system costs between $300,000 and $700,000.

On cross-examination, Dr. Phillips disputed that the same tests he performed would cost between $900 and $2,500 at a hospital. He believed that his charges are reasonable and that other physicians would agree with that assessment if they did the same work. He denied telling the plaintiff that she did not need to be concerned with the bill.

Dr. Charles Martinez, board certified in internal and nuclear medicine and director of nuclear medicine at Lutheran General Hospital, testified for the plaintiff as an expert witness as to the usual and customary charges for nuclear medicine in the greater Chicago-land area. At the hospital, the charges are determined by the cost of the material, the technologist’s pay, and the cost of the overhead of the area in which they worked. The trial court overruled Dr. Phillips’s objection to Dr. Martinez’s rendering an opinion as to whether Dr. Phillips’s charges were reasonable.

After reviewing Dr. Phillips’s charges, Dr. Martinez opined that the charges were not reasonable based upon his knowledge of what area hospitals and several imaging centers charge. According to Dr. Martinez, the charge for most of their complete scans, including the professional component, would be around $1,000. If the highest amount for the “technical professional component” were charged, the charge for doing the same work that Dr. Phillips did would be $2,509.

On cross-examination, Dr. Martinez acknowledged that he had never been in private practice doing nuclear medicine but stated that he did know someone who ran a private clinic. He further acknowledged that contracts with HMOs and other prepaid medical plans had a tremendous influence on what the hospital charged. He denied that without the existence of such plans the hospital would charge more. Lutheran General Hospital has eight gamma cameras, which are in use six hours a day. The technologists who perform the studies at the hospital are paid between $30,000 and $50,000 per year.

On redirect examination, Dr. Martinez testified that a colleague in private practice informed him that the usual and customary charge for these types of studies in his area was between $800 and $1,500.

On re-cross-examination, Dr. Martinez testified that of the $2,509 charge, $771 would be for the professional component, or the physician’s time, which would generally be one hour. The remaining $1,738 is the technical component. Conducting the scans is delegated to a technician.

The trial court found that there was no evidence controverting that Dr. Phillips performed the services listed on his bill but there was conflicting evidence on the issue of reasonableness. The trial court found that the reasonable charge for the services Dr. Phillips performed was $2,509 and ordered Dr. Phillips’s lien adjudicated in that amount. This appeal followed.

Prior to addressing the merits of this case, we note that Dr. Phillips filed a motion to strike a portion of the plaintiffs brief that we ordered taken with the case. Based on our review of the record, we grant Dr. Phillips’s motion to strike and, therefore, will not consider the statement in the plaintiffs brief of which Dr. Phillips complained.

Dr.

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Bluebook (online)
703 N.E.2d 613, 301 Ill. App. 3d 560, 234 Ill. Dec. 752, 1998 Ill. App. LEXIS 806, Counsel Stack Legal Research, https://law.counselstack.com/opinion/temesvary-v-houdek-illappct-1998.