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Introduced Version Senate Bill 572 History

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Key: Green = existing Code. Red = new code to be enacted

WEST virginia legislature

2022 regular session

Introduced

Senate Bill 572

By Senator Takubo

[Introduced February 03, 2022; referred
to the Committee on the Judiciary]

A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §55-7-32; and to amend and reenact §57-5-4j of said code, all relating to preventing compensatory damage awards for medical expenses from including sums that the claimant has not and will not pay for medical services or treatment.

Be it enacted by the Legislature of West Virginia:


CHAPTER 55. ACTIONS, SUITS AND ARBITRATION; JUDICIAL SALE.


ARTICLE 7. ACTIONS FOR INJURIES.


§55-7-32. Damages for medical services or treatment received; abrogation of common law rule; limitation of damages.

(a) The Legislature hereby declares that the purpose of this section is to abrogate the common law collateral source rule in determining the sums recoverable by injured persons as damages for medical expenses and to prevent compensatory damage awards for the value of necessary and reasonable medical services or treatment from exceeding the sums accepted by the health care provider for treating the injured party. The Legislature further declares that the decision of the Supreme Court of Appeals of West Virginia in Kenney v. Liston, Case No. 13-0427 (W.Va. June 4, 2014), and any other decision of the Supreme Court of West Virginia inconsistent with this legislation, is contrary to the Legislature’s intent and is superseded by the enactment of this section.

(b) Definitions:

“Health care provider” includes all hospitals, institutions, laboratories, doctors, physicians, optometrists, chiropractors, dentists, nurses, therapists and any other medical or health care facility, professionals or persons who diagnose, evaluate, treat, or otherwise deliver medical services or treatment to a plaintiff. 

“Medical care plan” means any medical care insurance, health care insurance, health benefit plan, employer-provided health care plan or medical insurance, workers’ compensation insurance, Medicaid, Medicare, other public or government-sponsored health care insurance or benefit program, or other similar source available to pay for services provided to the injured person at the time or after the medical services or treatment were provided.

“Medical services or treatment” means any actions taken by a health care provider to observe, identify, diagnose, stabilize, address, ameliorate, correct, remedy, rehabilitate, manage, combat or care for a plaintiff’s injury, condition, disease or disorder, or symptoms of a plaintiff’s injury, condition disease or disorder. The term includes any equipment, facilities, medicines, drugs, prescriptions, devices, or products provided or applied to a plaintiff by a health care provider or consumed by a plaintiff at a health care provider’s direction.

(c) In an action by any person or a legal representative to recover damages resulting from death or injury to a person, the damages that may be recovered for the reasonable value of any necessary and reasonable medical services or treatment may not exceed:

(1) Sums actually paid by or on behalf of the injured person to the health care providers who rendered the necessary and reasonable medical services or treatment to the injured person;

(2) Sums actually necessary to satisfy charges that have been incurred and at the time of trial are still owing and payable to health care providers for reasonable and necessary medical services or treatment rendered to the injured person; and

(3) Sums actually necessary to provide for any future necessary and reasonable medical services or treatment for the injured person.

CHAPTER 57. EVIDENCE AND WITNESSES.


ARTICLE 5. MISCELLANEOUS PROVISIONS.


§57-5-4j. Hospital records; evidence of reasonableness of medical expenses.

(1) Proof that medical, hospital and doctor bills were paid or incurred because of any an illness, disease or injury shall be is prima facie evidence that such the bills so paid or incurred were necessary and reasonable. Proof that any health care provider’s bills were incurred but resolved, in whole or in part, by way of contractual discount, reduction, disallowance, gift or write-off and not paid may not be used to establish the necessity or reasonableness of medical expenses.

(2) Evidence to establish the reasonable value of medical service or treatment may not include any reference to amounts that exceed the sums actually paid by or on behalf of the injured party, regardless of the source of payment, to satisfy the financial obligation for medical services or treatment that the injured party received, and evidence of the sums actually necessary to satisfy the financial obligation for medical services or treatment rendered to the injured party that have been incurred but not yet satisfied. This evidence may not include any reference to amounts that exceed the sum for which the unpaid charges could be satisfied if submitted to any medical care plan covering the injured party or for which the injured party is eligible, regardless of whether the incurred but not yet satisfied charges have been or will be submitted to the injured party’s medical care plan. If the injured party is not covered by any medical care plan and is not eligible for any medical care plan, evidence of the reasonable value of medical services or treatment incurred but not yet satisfied may not include any reference to amounts that exceed the Medicare reimbursement rate in effect at the time the injured party’s services or treatment occurred for the specific medical services or treatment rendered to the injured party.

(3) Evidence to establish the reasonable value of any future medical service or treatment of the injured party may not include any reference to amounts that exceed the sums actually necessary to satisfy the financial obligation for any reasonable and necessary future medical services or treatment. This evidence may not include any reference to amounts that exceed the sums for which the future charges of health care providers could be satisfied if submitted to any medical care plan covering the injured party or any medical care plan for which the injured person is eligible. If the injured person is not covered by any medical care plan and is not eligible for any medical care plan, evidence of the reasonable present value of any future reasonable and necessary medical or health care or treatment may not include any reference to amounts that exceed the Medicare reimbursement rate in effect at the time of trial for the reasonable and necessary future medical services or treatment of the injured party.

 

NOTE: The purpose of this bill is to prevent compensatory damage awards for medical expenses from including sums that the claimant has not and will not pay for medical care or treatment.

Strike-throughs indicate language that would be stricken from a heading or the present law, and underscoring indicates new language that would be added.

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