Opinion ID: 2149805
Heading Depth: 2
Heading Rank: 2

Heading: Disclosure of Payments Made by Medicare and Medicaid.

Text: Before trial, both parties sought determinations on the admissibility of Whigham's medical expenses. Whigham was charged almost $800,000 for the medical care he received concerning his thyroidectomy and subsequent complications. His health care providers accepted $304,844 from Medicare, Iowa Medicaid, and Illinois Medicaid [1] in satisfaction of the charges. The estate sought to introduce the amount billed as probative of the extent of Whigham's injury. The estate also claimed it was entitled to request damages for the amount actually paid because Medicare and Medicaid would have to be reimbursed in the event of any recovery in this case. Finally, the estate argued the jury should not be told the bills were paid by Medicare and Medicaid. Dr. Otoadese sought to exclude all evidence of medical expenses arguing Iowa Code section 147.136 (2003) barred recovery of such expenses. [2] The district court held the estate could claim damages for the amount it would have to repay Medicare and Medicaid. The court also ruled the jury could be told the bills had been paid by Medicare and Medicaid. On appeal, we are asked to determine whether the trial court abused its discretion in allowing Dr. Otoadese to present evidence the bills were paid by Medicare and Medicaid. [3] The estate contends the trial court's ruling had the effect of introducing the issue of insurance into [the] trial. It argues the jury . . . could conclude that there should not be any verdict in [the estate]'s favor for the reason that [Whigham's] medical expenses had been covered by insurance. [4] The estate claims admitting evidence of a plaintiff's medical insurance coverage is just as improper as admitting evidence of a defendant's liability insurance coverage. However, assuming Medicare and Medicaid are analogous to insurance, this contention is not supported by Iowa law. Iowa Rule of Evidence 5.411 states [e]vidence that a person was or was not insured against liability is not admissible upon the issue of whether the person acted negligently or otherwise wrongfully. There is no similar rule regarding medical insurance. In fact, Iowa Code section 668.14 expressly permits the admission of evidence concerning a plaintiff's medical insurance (but not a state or federal program) in personal injury cases. [5] Moreover, the reasons for excluding evidence of the existence of liability insurance  knowledge of a defendant's liability insurance may influence jurors to bring in a verdict against a defendant on insufficient evidence [and may] cause[ ] jurors to bring in a larger verdict than they would if they believed the defendant would be required to pay it, Laguna v. Prouty, 300 N.W.2d 98, 101 (Iowa 1981)are not applicable to medical insurance coverage. See Iowa Code § 668.14(2) (requiring a court to permit evidence and argument as to the plaintiff's costs for procuring medical insurance and any rights of indemnification or subrogation by the insurance company). Had the jury found Dr. Otoadese was negligent, we doubt it would have returned a verdict in the doctor's favor simply because government programs paid for Whigham's medical expenses. Moreover, the jury was informed Medicare and Medicaid were entitled to reimbursement out of any recovery in the event the jury determined the estate was entitled to damages. We cannot say the district court ruling prejudiced the estate. Therefore, the district court properly denied the estate's motion for a new trial on this ground.