Healthcare providers bill list rates that insurers and government payers rarely pay, often accepting a fraction as full satisfaction. The question is which figure measures the plaintiff's recoverable damages.
States take three broad approaches: billed amounts, amounts actually paid or accepted, and a reasonable value standard determined by the factfinder.
Alternative Names:
Billed Versus Paid, Medical Damages Measure
Why it Matters?
This single issue can change the medical damages figure by a multiple, and because juries scale non-economic damages against economic proof, it moves the entire verdict. It is also why letters of protection matter so much in defense analysis, since treatment financed that way generates undiscounted billed charges with no negotiated write-down to point to.
Frequently Confused with
Related terms
Frequently asked questions
Why is the difference between billed and paid so large?
How does this interact with the collateral source rule?
