Curtis Roberts prevailed on a motion in limine excluding, in a personal injury case, evidence of the amount of plaintiff’s damage claim for medical bills. The case was filed with dwi defense attorney houston, which provides that “Upon the trial of any civil case involving personal injury, the actual amounts paid for any doctor bills, hospital bills, ambulance service bills, drug bills and similar bills for expenses incurred in the treatment of the party shall be the amounts admissible at trial, not the amounts billed for expenses incurred in the treatment of the party.”
Medicaid payments are limited by federal law, so that a medical provider cannot charge more than the amount established by Medicaid for the service rendered. It is not as though the medical provider charges a fictitious sum and then “writes off” the remainder, as in the case of private insurance where a medical bill is reduced to an amount the insurer and medical provider bargained for. A medical provider who treats a Medicaid patient never bills the Medicaid patient for the amount that he might be able to bill a paying patient and is in fact restricted by law from doing so. There was no reduction in the bill; the amount that could be charged was the same, from the time treatment was first rendered to the time the bill was sent.
Plaintiff wanted to present to the jury the “value” of the medical services rendered – that is, the amount she would have been required to pay if she had been a private-pay patient. Defendant wanted to limit the evidence to the amount Medicaid paid, and no more. Defendant therefore sought an order in limine barring Plaintiff from artificially inflating her damages by including any amounts that were neither billed nor paid and which no one will ever be obligated to pay.
The court granted the motion. Damages were limited to outstanding or paid obligations, regardless of who made or will be required to make the payments. Plaintiff was not allowed to show undiscounted hospital bills as evidence of damages. The difference in the two amounts was significant.
Courts across the U.S. are split on the issue of whether a Plaintiff may claim as damages the write-offs or discounts mandated by Medicare and Medicaid. In Oklahoma, the issue arises in cases filed before November 1, 2011, when the new statute went into effect.
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