Recoverable Medical Damages Are Rarely What You Are Billed in Texas

Texas Courts have recognized in the convoluted world of hospital billing that patients rarely pay or otherwise become obligated to a hospital’s “full” charges. Medicare, Medicaid, HMOs, and private insurers are generally subject to discounted rates under law, or through their contracts with hospitals and other providers. As the Texas Supreme Court held in the 2011 case of Haygood v. de Escabedo, 356 S.W.3d 390 (Tex. 2012), since a claimant is not entitled to recover medical expenses that a provider is not entitled to be paid, evidence of such charges is irrelevant to the issue of damages.  Accordingly, only evidence of recoverable medical expenses is admissible at trial. It follows that the attorney representing a plaintiff in a case seeking the recovery of medical expenses, paid or incurred in the past, or sought to be recovered in the future, must take care in presenting the evidence to the judge and/or jury to not run afoul of this rule. In fact, the submission of any evidence of what the “full” charges are could introduce potentially reversible error into a plaintiff’s case and risk voiding a favorable verdict.

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