This whitepaper focuses on damages a plaintiff can recover for past medical expenses in personal injury cases in Texas courts. We note damages for future medical expenses raise different issues and that discussion is outside the scope of this paper.
Plaintiffs in Texas personal injury cases may only recover the reasonable value of the past medical expenses. However, Texas courts have held that billed charges are largely unrelated to the reasonable value of the services. The negotiated rates of providers and health plans in a medical market or rates set by government are all relevant evidence of reasonable value. This blog post discusses the ability of defendants in personal injury litigation to obtain evidence on the reasonable value of medical services through discovery
This blog discusses post-COVID-19 syndrome, also known as Long COVID, and raises questions about how it will affect personal injury litigation. It also discusses the impacts of Long COVID on the economy and labor market, and outlines ways employers might accommodate those with Long COVID to keep them in their jobs for the benefit of both the employee and the employer.
RPC is expanding its services to attorneys with personal injury cases in Louisiana. While we have worked on many cases involving Louisiana residents suing in Texas or federal courts, we have worked on many fewer cases tried under Louisiana law. So RPC consultants will know the differences in Texas and Louisiana law on damages in personal injury cases, we retained Spencer King, an attorney with the firm of King & Jurgens, LLC, to prepare a memorandum for our internal use.
In 2019 the Texas Legislature session passed several bills to limit what freestanding emergency departments (FSEDs) charge. One statute authorizes action by the Attorney General if an FSED’s charges are “unconscionable” in comparison to local hospital charges for similar emergency services. Most hospitals update their chargemasters at least annually. To ensure their charges do not become unconscionable, RPC recommends FSEDs review their chargemasters annually. RPC can help FSEDs set their charges to avoid them being “unconscionable.” We can also help FSEDs resolve payment disputes with health plans.
The cost of future medical care is often the largest component of economic damages sought and awarded in personal injury cases. RPC can calculate the reasonable value of goods and services in life care plans based on commercial health insurance allowed amounts (i.e. the market value of healthcare) or on specific fee schedules the plaintiff may be eligible for, such as Medicare, Medicaid, or Workers’ Compensation.
A Look Back at RPC in 2022 and Forward to 2023
On December 28, 2022, the Third Court of Appeals in Austin issued its latest decision in the seemingly never-ending litigation over the stop-loss exception to the Division’s 1997 Inpatient Hospital Fee Guideline. Stone Loughlin Swanson publishes a newsletter focusing on Texas workers’ compensation law and the December 2022 issue has an article by James Loughlin discussing the history and issues in the case. Mr. Loughlin has graciously let RPC reprint his article. It has links to the recent decision and to other important documents. We think you will find it an interesting read.
Considering Developing an ASC-Based Cardiac Catheterization Laboratory? Research & Planning Consultants and Health Management Associates have prepared a white paper explaining guidance on safety, efficacy, and patient selection for diagnostic and therapeutic cardiac catheterization procedures in Ambulatory Surgery Centers (ASCs) from medical professional societies and Medicare.
Past and future medical expenses are major elements of damages in personal injury cases. In many cases they are by far the largest element of “hard” damages and are used as a reference point for jurors in awarding pain and suffering and other “soft” damages. While plaintiffs should be fairly compensated for their medical expenses, the expenses should not be unfairly inflated. Recently we modified an actual report on reasonable charges and reasonable value for a defendant to create a sample report showing RPC’s data sources and methods of analysis for part medical expenses. The sample report is available to download here.