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Admissibility of Paid Amounts as Evidence of Reasonable Value of Medical Expenses, a 50 State Overview

Admissibility of Paid Amounts as Evidence of Reasonable Value of Medical Expenses, a 50 State Overview

Compiled by Harris, Karstaedt, Jamison & Powers, P.C.

July 19, 2012

Alabama– paid amounts recoverable along with amounts plaintiff paid for coverage:

(a) In all civil actions where damages for any medical or hospital expenses are claimed and are legally recoverable for personal injury or death, evidence that the plaintiff’s medical or hospital expenses have been or will be paid or reimbursed shall be admissible as competent evidence. In such actions upon admission of evidence respecting reimbursement or payment of medical or hospital expenses, the plaintiff shall be entitled to introduce evidence of the cost of obtaining reimbursement or payment of medical or hospital expenses. Ala.Code § 12-21-45. Challenged and held to be constitutional in Marsh v. Green, 782 So.2d 223 (Ala. 2000).

Alaska– paid amounts inadmissible. Under very limited circumstances, post judgment defendant can seek reduction of an award by amounts plaintiff received or will receive. Alaska Stat. § 09.17.070(a).

Arizona– paid amounts inadmissible. Lopez v. Safeway Stores, Inc., 129 P.3d 487 (Ariz. App. 2006).

Arkansas– paid amounts inadmissible. Johnson v. Rockwell Automation, Inc., 308 S.W.3d 135, 142 (Ark. 2009) (in 2003 a Rule of Evidence was enacted that allowed paid only, but it was found unconstitutional in 2009 due to a particular provision in the Arkansas constitution).

California– paid amounts inadmissible, verdict in excess of paid amounts will be reduced to paid amounts. Howell v. Hamilton Meats & Provisions, Inc., 257 P.3d 1130, 1145 (Cal. 2011).

Connecticut– paid amounts inadmissible. Public Act No. 12-142 allows plaintiffs to submit bills into evidence but allows defendants to call experts regarding the reasonable value of bills. It is not clear whether the procedures available under Jones v. Kramer, 267 Conn. 336, 838 A.2d 170 (2004) are still available (defendants present special interrogatories to the jury regarding medical expenses. Then post trial defendant asks the Court to reduce the award by amounts paid for expenses. Plaintiff can seek recovery of premiums.)

Delaware– paid amounts inadmissible. Mitchell v. Haldar, 883 A.2d 32 (Del. 2005); Onusko v. Kerr, 880 A.2d 1022 (Del. 2005).

District of Columbia– paid amounts inadmissible. Hardi v. Mezzanotte, 818 A.2d 974 (D.C. App. 2003).

Florida– paid amounts inadmissible, but there is a post verdict offset of billed amounts. Goble v. Frohman, 901 So. 2d 830 (Fla. 2005). Defense can call experts on reasonable value of medical expenses. State Farm Mut. Auto. Ins. Co. v. Bowling, 81 So.3d 538 (Fla. App. 2 Dist. 2012) (this is a great case dealing with expert qualifications to opine on reasonable value of medical expenses).

Georgia– paid amounts inadmissible. Olariu v. Marrero, 549 S.E.2d 121 (Ga. App. 2001).

Hawaii– paid amounts inadmissible. Bynum v. Magno, 101 P.3d 1149 (Haw. 2004).

Idaho– paid only. Dyet v. McKinley, 81 P.3d 1236 (Idaho 2003).

Illinois– paid amounts inadmissible. Wills v. Foster, 892 N.E.2d 1018 (Ill. 2008).

Indiana– both admissible. Stanley v. Walker, 906 N.E.2d 852 (Ind. 2009).

Iowa– both admissible. Pexa v. Auto Owners Insurance Co., 686 N.W. 2d 150 (Iowa 2004).

Kansas– both admissible. Martinez v. Milburn Industries, Inc., 233 P.3d 205 (Kan. 2010).

Kentucky– paid amounts inadmissible. Baptist Healthcare Systems v. Miller, 177 S.W.3d 676 (2005).

Louisiana– paid amounts inadmissible. Bozeman v. State, 879 So.2d 692 (La. 2004). (There may be an exception for Medicaid payments).

Maine– no Supreme Court decision or statute, but the Superior Court has held that “[i]t is for the fact finder to decide, based on evidence not only of the amount of the payments made, but also based on evidence of the amounts billed by the medical service providers and any other relevant evidence not implicating the collateral source rule, what the “reasonable value” of those medical services is.” Barday v. Donnelly, 2006 WL 5218270 (Me.Super.Ct. Jan. 27, 2006).

Maryland– paid amounts inadmissible, post verdict reduction of paid only Lockshin v. Semsker, 987 A.2d 18, 35 (Md. 2010).

Massachusetts– paid amounts inadmissible. Scott v. Garfield, 912 N.E.2d 1000 (Mass. 2009).

Michigan – paid amounts inadmissible, post verdict reduction paid only. MCL 600.6303

Minnesota– paid amounts inadmissible, post-verdict reduction of billed amount (less premiums) is allowed. Swanson v. Brewster, 784 N.W.2d 264, 282 (Minn. 2010).

Mississippi: paid amounts inadmissible. Brandon HMA v. Bradshaw, 809 So.2d 611 (Miss. 2001). (Except if tortfeasor also provided the medical care pursuant to its obligation as a Medicare provider. McGee v. River Region Medical Center, 59 So.3d 575, 581 (Miss. 2011)).

Missouri– both are admitted, there is a presumption that paid amounts represents reasonable value. Deck v. Teasley, 322 S.W.3d 536 (Mo. banc 2010).

Montana – no Supreme Court decision or statute directly addresses the issue, but Chapman v. Mazda Motor of America, Inc., 7 F.Supp.2d 1123 (D.Mont.1998) suggests that only paid amounts are recoverable, while written off amounts may be admissible “to show the jury the severity and the extent” of injuries.

Nebraska– paid amounts inadmissible. Fickle v. State, 274 Neb. 267, 759 N.W.2d 113 (Neb. 2007)

Nevada -unresolved. In cases involving worker’s compensation benefits, amounts paid are admissible. Tri-County Equipment & Leasing v. Klinke, — P.3d —-, 2012 WL 2459701 (Nev. June 28, 2012).

New Hampshire– probably paid amounts inadmissible, but defendant may rebut that billed amounts are the reasonable value medical services. See Reed v. National Council of Boy Scouts of America, Inc., 706 F.Supp.2d 180 (D.N.H. 2010)

New Jersey – not decided.

New Mexico – not decided.

New York– paid amounts inadmissible, post verdict offset allowed Kastick v. U-Haul Company of Western Michigan, 740 N.Y.S.2d 167 (N.Y. App. Div. 2002).

North Carolina: paid amounts only, for all cases arising after 10/1/11, NC Rule of Evidence 414.

North Dakota – not clear but Dewitz by Nuestel v. Emery, 508 N.W.2d 334 (N.D.1993) appears to suggest it will be billed only.

Ohio– both are admissible. Robinson v. Bates, 857 N.E.2d 1195 (Ohio 2006) and Jaques v. Manton, 125 Ohio St.3d 342, 928 N.E.2d 434 (Ohio 2010). However expert testimony may be required to lay foundation.

Oklahoma– evidentiary issue unresolved. For all cases filed after 11/1/11, only paid amounts are recoverable, but statute does not address evidentiary issues. Okla.Stat.tit.12, § 3009.1

Oregon– paid amounts inadmissible. White v. Jubitz Corp., 219 P.3d 566 (Ore. 2009).

Pennsylvania– paid only. Moorhead v. Crozer Chester Medical Center, 765 A.2d 786 (Pa. 2001)

Rhode Island– G.L.1956 § 9-19-27, an itemized medical bill, “shall be admissible as evidence of the fair and reasonable charge for the services and/or the necessity of the services or treatment” cross examination and rebuttal evidence is permitted.

South Carolina– paid amounts inadmissible. Covington v. George, 597 S.E.2d 142 (S.C. 2004); Haselden v. Davis, 579 S.E.2d 293 (S.C. 2003).

South Dakota– paid amounts inadmissible. Papke v. Harbert, 738 N.W. 2d 510 (S.D. 2007).

Tennessee – paid amounts inadmissible, however, “a defendant is permitted to introduce relevant evidence regarding necessity, reasonableness, and whether a claimed service was actually rendered.” Fye v. Kennedy, 991 S.W.2d 754 (Tenn.App.1998).

Texas– only paid amounts are admissible or recoverable. Haygood v. De Escabedo, 356 S.W.3d 390 (Tex. 2011)

Utah– not decided (but see Amos v. W.L. Plastics, Inc., Slip Copy, 2010 WL 360772, *2 (D.Utah 2010)(“[t]he Court further finds that the Utah Supreme Court would follow the majority rule concerning medical bill write-offs.”)

Vermont – undecided by State Supreme Court but Federal Court held paid amounts were inadmissible, though defendant could “introduce any relevant evidence of the reasonable value of medical services that is not barred by the collateral source rule. This may include, for example, evidence as to what the provider usually charges for the services provided, or what other providers usually charge. … evidence may be introduced concerning the range of payments that the providers accept for the types of medical services that the plaintiff received.” Melo v. Allstate Ins. Co., 800 F.Supp.2d 596 (D.Vt.2011) (internal citations omitted).

Virginia– paid amounts inadmissible Radvany v. Davis, 551 S.E.2d 347 (Va. 2001); Acuar v. Letourneau, 531 S.E.2d 316 (Va. 2000).

Washington – paid amounts are inadmissible, but defendant may challenge the reasonableness of bills “by presenting testimony that the charges were unreasonable.” Hayes v. Wieber Enterprises, Inc., 105 Wash.App. 611, 20 P.3d 496 (Wash.App. Div. 3 2001)

West Virginia – not clear, but probably paid amounts inadmissible. See Keesee v. General Refuse Service, Inc., 216 W.Va. 199, 604 S.E.2d 449 (W.Va. 2004)

Wisconsin– paid amounts inadmissible Leitinger v. DBart, Inc., 736 N.W. 2d 1 (Wis. 2007).

Wyoming – not decided.

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