SLS 25RS-417 ORIGINAL
2025 Regular Session
SENATE BILL NO. 231
BY SENATOR REESE
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
CIVIL PROCEDURE. Provides for recoverable medical expenses. (1/1/26)
1 AN ACT
2 To amend and reenact R.S. 9:2800.27 and to repeal R.S. 9:2800.27 (F) and (G), relative to
3 civil actions; to provide relative to recoverable medical expenses; to provide relative
4 to the amount billed and the amount paid in certain circumstances; to provide relative
5 to the calculation of certain damages; to provide relative to admissible evidence; to
6 provide relative to certain definitions; to provide relative to health insurance
7 coverage; to provide relative to health care providers; to provide relative to obtaining
8 discovery in certain circumstances; to provide relative to expert testimony in certain
9 circumstances; to provide relative to agreements between a health care provider and
10 a third party; to provide relative to the attorney-client privilege and other privileges;
11 to provide for prospective application; to provide for an effective date; and to
12 provide for related matters.
13 Be it enacted by the Legislature of Louisiana:
14 Section 1. R.S. 9:2800.27 is hereby amended and reenacted to read as follows:
15 ยง2800.27. Recoverable past medical expenses; collateral sources; limitations;
16 evidence
17 A. For the purpose of this Section:
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SLS 25RS-417 ORIGINAL
1 (1) "Contracted medical provider" means any in-network medical provider
2 that has entered into a contract or agreement directly with a health insurance issuer
3 or with a health insurance issuer through a network of providers for the provision of
4 covered healthcare services at a pre-negotiated rate, or any medical provider that has
5 billed and received payment for covered healthcare services from Medicare when the
6 provider is a participating provider in those programs.
7 (2) "Cost of procurement" means the cost paid by or on behalf of the claimant
8 to procure the benefit paid by a health insurance issuer or Medicare and the cost of
9 procurement of the award of medical expenses, including but not limited to
10 contracted attorney fees and health insurance premiums paid.
11 (3) "Cost sharing" means copayments, coinsurance, deductibles, and any
12 other amounts which have been paid or are owed by the claimant to a medical
13 provider.
14 (4)(2) "Health insurance issuer" means any health insurance coverage through
15 a policy or certificate of insurance subject to regulation of insurance under state law,
16 a health maintenance organization, an employer-sponsored health plan, the Office
17 of Group Benefits, or an equivalent federal or state health plan.
18 (3) "Health insurance coverage" means benefits consisting of health care
19 services provided through insurance, or reimbursement, which includes items
20 and services paid for as health care services under any hospital or medical
21 service policy or certificate, hospital or medical service plan contract, preferred
22 provider organization agreement, or health maintenance organization contract
23 offered by a private health insurer, the Office of Group Benefits, Medicare,
24 Medicaid, Louisiana Workers' Compensation Law or equivalent state health
25 plans.
26 (5)(4) "Medical provider" means any healthcare provider, hospital,
27 ambulance service, or their heirs or assignees.
28 (5) "Health care provider" means a physician or health care practitioner
29 licensed, certified, and registered to perform specified health care services in
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SLS 25RS-417 ORIGINAL
1 accordance with the applicable law and any facility or institution providing
2 health care services, including but not limited to a hospital, licensed inpatient
3 center, ambulatory, surgical or treatment center, skilled nursing facility,
4 inpatient hospice facility, residential treatment center, diagnostic laboratory or
5 imaging center, or rehabilitation or therapeutic health setting.
6 B. In cases where a claimant's medical expenses have been paid, in whole or
7 in part, by a health insurance issuer or Medicare to a contracted medical provider,
8 the claimant's recovery of medical expenses is limited to the amount actually paid
9 to the contracted medical provider by the health insurance issuer or Medicare, and
10 any applicable cost sharing amounts paid or owed by the claimant, and not the
11 amount billed. The court shall award to the claimant forty percent of the difference
12 between the amount billed and the amount actually paid to the contracted medical
13 provider by a health insurance issuer or Medicare in consideration of the claimant's
14 cost of procurement, provided that this amount shall be reduced if the defendant
15 proves that the recovery of the cost of procurement would make the award
16 unreasonable. The determination of this award shall be made only in accordance with
17 the provisions of Subsection F of this Section.
18 C. In cases where a claimant's medical expenses have been paid, in whole or
19 in part, by Medicaid to a medical provider, the claimant's recovery of medical
20 expenses actually paid by Medicaid is limited to the amount actually paid to the
21 medical provider by Medicaid, and any applicable cost sharing amounts paid or
22 owed by the claimant, and not the amount billed.
23 D. The recovery of past medical expenses other than those provided by
24 Subsection B or C of this Section shall be limited to amounts paid to a medical
25 provider by or on behalf of the claimant, and amounts remaining owed to a medical
26 provider, including medical expenses secured by a contractual or statutory privilege,
27 lien, or guarantee. The determination of this award shall be made only in accordance
28 with Subsection F of this Section.
29 E.C. In cases where a claimant's medical expenses are paid pursuant to the
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SLS 25RS-417 ORIGINAL
1 Louisiana Workers' Compensation Law as provided in R.S. 23:1020.1 et seq., a
2 claimant's recovery of medical expenses is limited to the amount paid under the
3 medical payment fee schedule of the Louisiana Workers' Compensation Law.
4 F.D. In a jury trial, only after a jury verdict is rendered may the court receive
5 evidence related to the limitations of recoverable past medical expenses provided by
6 Subsection B or D of this Section. The jury shall be informed only of the amount
7 billed by a medical provider for medical treatment. Whether any person, health
8 insurance issuer, or Medicare has paid or has agreed to pay, in whole or in part, any
9 of a claimant's medical expenses, shall not be disclosed to the jury. In trial to the
10 court alone, the court may consider such evidence.
11 Except as provided in Subsections B and C of this Section, any party may
12 introduce evidence of the amount billed and the amount paid to establish the
13 basis for, and reasonableness of, an award for medical expenses. Any agreement
14 between a health care provider and a third party responsible for the payment,
15 financing or collection of medical expenses shall be admissible as evidence. The
16 trier of fact shall make a determination of the amount of medical expenses to
17 award, if any, after all evidence has been presented.
18 G.E. This Section shall not apply in cases brought pursuant to R.S. 40:1231.1
19 et seq., or 1237.1 et seq.
20 Section 2. The provisions of this Act shall have prospective application only and
21 shall not apply to causes of action filed prior to the effective date of this Act.
22 Section 3. The provisions of this Act shall become effective on January 1, 2026.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Senate Legislative Services.
The keyword, summary, and digest do not constitute part of the law or proof
or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
DIGEST
SB 231 Original 2025 Regular Session Reese
Present law (R.S. 9:2800.27) provides that certain medical expenses are recoverable and
provides limitation on admissibility of evidence related to recoverable past medical
expenses.
Present law defines "contracted medical provider"; "cost of procurement"; "cost sharing";
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SLS 25RS-417 ORIGINAL
"health insurance issuer"; and "medical provider".
Proposed law removes the definitions of "contracted medical provider" and "cost of
procurement" from present law.
Proposed law provides that "health insurance coverage" means benefits consisting of health
care services provided through insurance, reimbursement, or otherwise, which includes items
and services paid for as health care services under any hospital or medical service policy or
certificate, hospital or medical service plan contract, preferred provider organization
agreement, or health maintenance organization contract offered by a private health insurer,
the Office of Group Benefits, Medicare, Medicaid, Louisiana Workers' Compensation Law
or equivalent state health plans.
Proposed law provides that "health care provider" means a physician or other health care
practitioner licensed, certified, and registered to perform specified health care services in
accordance with the applicable law and any facility or institution providing health care
services, including but not limited to a hospital, licensed inpatient center, ambulatory,
surgical or treatment center, skilled nursing facility, inpatient hospice facility, residential
treatment center, diagnostic laboratory or imaging center, or rehabilitation or therapeutic
health setting.
Present law provides that in cases where a claimant's medical expenses have been paid, in
whole or in part, by a health insurance issuer or Medicare to a contracted medical provider,
the claimant's recovery of medical expenses is limited to the amount actually paid to the
contracted medical provider by the health insurance issuer or Medicare, and any applicable
cost sharing amounts paid or owed by the claimant, and not the amount billed. Present law
provides that the court shall award to the claimant 40% of the difference between the amount
billed and the amount actually paid to the contracted medical provider by a health insurance
issuer or Medicare in consideration of the claimant's cost of procurement, provided that this
amount shall be reduced if the defendant proves that the recovery of the cost of procurement
would make the award unreasonable. Present law provides that the determination of the
award shall be made only in accordance with the provisions of present law.
Proposed law repeals present law.
Present law provides that in cases where a claimant's medical expenses have been paid, in
whole or in part, by Medicaid to a medical provider, the claimant's recovery of medical
expenses actually paid by Medicaid is limited to the amount actually paid to the medical
provider by Medicaid, and any applicable cost sharing amounts paid or owed by the
claimant, and not the amount billed.
Proposed law retains present law.
Present law provides that the recovery of past medical expenses other than those provided
by present law shall be limited to amounts paid to a medical provider by or on behalf of the
claimant, and amounts remaining owed to a medical provider, including medical expenses
secured by a contractual or statutory privilege, lien, or guarantee. Present law provides that
the determination of the award shall be made only in accordance with present law.
Proposed law repeals present law.
Present law provides that in cases where a claimant's medical expenses are paid pursuant to
the Louisiana Workers' Compensation Law as provided in present law, a claimant's recovery
of medical expenses is limited to the amount paid under the medical payment fee schedule
of present law.
Proposed law retains present law.
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words in boldface type and underscored are additions. SB NO. 231
SLS 25RS-417 ORIGINAL
Present law provides that in a jury trial, only after a jury verdict is rendered may the court
receive evidence related to the limitations of recoverable past medical expenses provided by
present law. Present law further provides that the jury shall be informed only of the amount
billed by a medical provider for medical treatment. Present law provides that whether any
person, health insurance issuer, or Medicare has paid or has agreed to pay, in whole or in
part, any of a claimant's medical expenses, shall not be disclosed to the jury, but that in trial
to the court alone, the court may consider such evidence.
Proposed law repeals present law.
Proposed law provides that, except as provided in present law, any party may introduce
evidence of the amount billed and the amount paid to establish the basis for, and
reasonableness of, an award for medical expenses. Further provides that any agreement
between a health care provider and a third party responsible for the payment, financing or
collection of medical expenses shall be admissible as evidence.
Proposed law provides that the trier of fact shall make a determination of the amount of
medical expenses to award, if any, after consideration of all evidence presented.
Present law provides that present law shall not apply in cases brought pursuant to present
law (Medical Malpractice and Malpractice Liability for State Services).
Proposed law retains present law and provides that proposed law shall not apply in cases
brought pursuant to present law (Medical Malpractice and Malpractice Liability for State
Services).
Proposed law provides that the provisions of proposed law shall have prospective application
only and shall not apply to causes of action filed prior to the effective date of proposed law.
Effective on January 1, 2026.
(Amends R.S. 9:2800.27, and repeals R.S. 9:2800.27 (F) and (G))
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Coding: Words which are struck through are deletions from existing law;
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