Companion bills bringing much needed reforms to §§41.0105 and 18.001, CPRC, will be heard in Senate and House committee next week. SB 207 by Sen. Charles Schwertner (R-Georgetown) will be heard in Senate State Affairs on Monday at 8 a.m. in the Senate Chamber. HB 1617 by Rep. Greg Bonnen will follow at Wednesday’s hearing of the House Judiciary & Civil Practices Committee beginning at 8 a.m. in E2.014. These bills are of immense importance to addressing the abuse of the paid or incurred rule and the process of proving up the reasonableness of medical charges. Please register your support of both bills.
A fundamental component of the 2003 health care liability and tort reform legislation, the paid or incurred rule assures that claimants can only recover health care expenses actually “paid or incurred,” meaning that they do not get windfall based on full bill (chargemaster) rates that are never paid or incurred by anybody, with or without health care coverage. Unfortunately, the trial bar has a work around for the rule that, in various ways, a claimant or provider does not submit the bill to a third-party payor, but instead takes the fee out of an eventual settlement or award. This practice entirely guts the paid or incurred rule and vastly inflates the real value of claims involving medical expenses. to make matters worse, trial judges routinely exclude the defendant’s billing expert from offering evidence to the jury of the reasonable value of the services. TCJL strongly supports SB 207 and HB 1617, which allow a defendant to introduce evidence of the actual amounts reimbursed for specified services at the time and place of the rendering of the service. This change will give the jury the information necessary to determine whether billed amounts are reasonable, restoring the purpose and intent of the paid or incurred rule in the first place.