Articles Posted in Motorcycle Accidents

A review of the Texas Supreme Court cases of Speegle v. Harris Methodist Health System and Haygood V. De Escabedo leads to the inescapable conclusion that while a Texas hospital may elect not to bill Medicare it is nonetheless limited to the Medicare rate when filing hospital liens against Medicare patients.

Medicare regulations allow a Texas hospital to pursue third-party liability insurance rather than Medicare. Hospitals frequently inflate their charges by five, ten or even twenty times the reasonable rate and then file a hospital lien pursuant to Texas Property Code sec. 55.004(d)(1) for the inflated amount. However, Texas Civil Practices and Remedies Code sec. 146.003(a) prohibits a hospital from billing an individual for amounts which they could have received from Medicare. In Speegle v. Harris Methodist Health System the Texas Supreme Court issued a very limited decision which held that Texas Civil Practices and Remedies Code Section 146.002(c) is preempted by Federal law to the extent that it requires a hospital to bill Medicare. While there are many Texas laws which regulate a hospital’s billing conduct, Section 146.002 (c) is the only section which was held by Speegle to be Federally preempted.

Speegle discussed Texas Property Code Chapter 55 hospital liens but did not hold that any of the Chapter 55 hospital lien provisions were Federally preempted. T.P.C. 55.004(d)(1) limits a Texas hospital lien to reasonable and regular charges. The reasonable and regular charge for Medicare patients is undeniably the Medicare rate. Speegle confirmed that if a hospital elects not to bill Medicare and to pursue liability insurance that the hospital must pay the applicable procurement costs. U.S. Dept. of Health and Human Services, Centers for Medicare and Medicaid Services, Medicare Secondary Payor (MSP) Manual, Chapter 2, Section 40.2 (2009). Costs of procurement include both attorneys fees, expert fees and litigation expenses.

Texas House Bill 1869 was passed by the Texas Legislature and signed into law by Governor Perry creating CPRC 140 which limits health insurance subrogation. After the Texas Supreme Court opinion in Fortis which effectively eliminated the Made Whole Doctrine health insurers were free to charge the usual exorbitant premiums, recover all their payments from tort victims, and keep the premiums.

Under CPRC 140 health insurers will still charge exorbitant premiums but will be limited to claiming only a portion of a tort victims recovery. For example, if an insured driver is injured in an auto accident and receives medical care for which the health insurance carrier pays $30,000 and the at-fault driver has a standard Texas minimum limits policy in the amount of $30,000 then in the past the carrier would try to claim the entire $30,000 and leave the injured insured with nothing for their injuries, lost wages and other damages. Under CPRC 140 the carrier is limited to a maximum “one-half of the covered individual’s gross recovery less attorney’s fees and procurement costs.” CPRC 140 produces a more equitable result.

For more information contact www.earldrottlaw.com.

A Parker County jury has awarded $5.2 million dollars to a motorcycle rider who lost his leg a result of injuries he sustained in a wreck with an automobile. The wreck occurred in October of 2010 when and elderly driver proceeded down Interstate 20 going the wrong direction and struck the motorcycle. Following the accident the Texas Department of Public Safety required the elderly driver to take a standard driving test which she failed on four consecutive attempts before passing the exam on her fifth try.

In a day and time when traffic moves at an ever increasing pace it is important that drivers be up to the demands of operating a motor vehicle for the safety of everyone on the roadway.

For more information contact www.earldrottlaw.com.

We tried another jury trial in Smith County this week. The case involved some pretty serious injuries arising out of a car wreck that occurred when the Defendant blew a stop sign and ran out into a highway. The impact was severe. The Defendants auto liability insurance company made a lowball offer and dug in. So many lawyers these days won’t go to trial and end up taking the insurance companies’ lowball offers that the insurance companies have gotten pretty arrogant in Texas. They called my office right before trial and told me that we should take their last offer. I guess being hard headed has its’ advantages because a Smith County jury awarded us more than seven times what the insurance company had offered. It was a good day for the good guys!

Ford recently recalled over 19,000 defective Fusions because of a headlight defect. It seems that the reflectors in the low beam headlights which are in use most of the time became hazy over time causing the brightness of the headlights to gradually decrease and create a safety hazard.

This is the second recall in as many weeks for the Fusion. Ford recently recalled new Fusions to repair leaky, overheating 1.6-liter engines that had the potential to catch fire. Ford claims to promptly remedy the safety problems in its’ vehicles.

For more information visit https://www.earldrottlaw.com/

For the second time the Texas Supreme Court refused to hear the case of Michelle Gaines. In 2006, 19 year old Michelle Gaines was a popular, athletic young lady who had received a soccer scholarship from Hill College. On June 19, 2006, an 18-wheeler hauling an oil rig ran a red light in Palestine causing Gaines to sustain a traumatic brain injury.

Gaines sued the driver of the tractor-trailer and the owner of the oil rig for whom the driver was working. The evidence showed that the 18-wheeler brakes were not working and that the rig owner, Pritchett, paid the driver over $96,000 AFTER the accident, arguably to keep the driver from implicating him. The jury heard evidence that after the accident the driver burned his business records.

The jury held both the driver and rig owner liable and awarded $8,000,000 in damages but the 12th Court of Appeals in Tyler overturned the verdict holding that there was not enough evidence to hold Prichett, the only party capable of paying the judgment, liable. The Texas Supreme Court twice refused to hear the Gaines’ appeal, leaving the Gaines family with no way to care for Michelle, who has the mental capacity of a 12 year old.