Evidence of Medical Bill Write-Offs in Ohio Injury Cases After Jacques v. Manton
Robinson v Bates, 2006-Ohio-6362 was a pivotal Ohio Supreme Court case that changed how medical bills were presented in an Ohio personal injury trial. Before Robinson, the only evidence that the jury heard relative to the plaintiff’s medical bills was the amount that the healthcare providers charged.
After the decision, however, the jury would now see the amount that was actually accepted by the healthcare provider from the plaintiff’s third party payor. The Robinson decision changed the personal injury landscape forever in Ohio. Recently, the Ohio Supreme Court reaffirmed its decision in Robinson.
On May 9, 2009, the Ohio Supreme Court decided the case of Jaques v. Manton, 2010-Ohio-1838. In Jaques, the court held that evidence of plaintiff’s paid medical bills may be presented in two ways. First, the plaintiff may present the amount of the medical bills charged to her while the defendant may present the amount that was actually paid. In essence, the plaintiff could tell the jury about the face value of her medical bills, while the defendant could tell the jury the portion of the balance that was written off by the third party payor. With this dual evidence, the jury would then determine the reasonableness and necessity of the charges for the plaintiff’s medical care.
The Supreme Court supported its decision by both the common law collateral source rule, and by R.C. 2315.20 which was enacted after Robinson. The prior lower courts erroneously held that R.C. 2315.20 superseded Robinson, and prevented the jury from hearing the evidence of the write-off.
R.C. 2315.20 deals with the collateral source rule in Ohio. This statute prevents defendants from reducing the plaintiff’s damages by the amount of the benefit she receives from other third parties which generally are insurance companies. This way, the defendant can not benefit from payments made to the plaintiff. This statute codified the common law collateral source rule, which had been in existence since 1970. But what happens when a portion of the medical bills are not actually paid because of a negotiated discount by the third party payor?
The admissibility of that “write down” according to Jaques, looks at the meaning of the “ reasonable value of medical care” required to treat plaintiff injuries. R.C. 2315.20 never applied to write- offs. The Jacques court found that because there are different insurance companies involved with the payment of the medical bills, the defendant should be responsible for that reasonable care standard. To accomplish this, the jury must be presented with both the charges as well as the paid amount.
The Jacques holding reaffirmed the Robinson decision and will let the jury decide the reasonable value of medical care by allowing at trial, both the evidence of the medical bill charged and the third party write-offs.