Medical Bill Write-offs Are Not Recoverable in Texas - Texas Supreme Court analyzes "paid or incurred" statute

Most medical billing records today list the healthcare providers' charges as well as the amounts actually paid to the providers after insurance adjustments and provider write-offs. In 2003, the Texas Legislature enacted a statute (Tx Civil Practice & Remedies Code § 41.0105) that purported to prevent civil plaintiffs from recovering these medical expenses that were not "actually paid or incurred". Since that time, there have been many debates in trial and appellate courts across Texas about the meaning and effect of the statute. Until today.

The Supreme Court of Texas issued an opinion today holding that this "paid or incurred" statute limits a plaintiff's recovery to only those sums actually paid or actually incurred. Consequently, a plaintiff cannot recover or even present evidence of the initial medical charges that are later written off or adjusted. This definitive interpretation of the statute by the Texas Supreme Court should have a significant impact on the amounts plaintiffs are able to seek and recover for medical expenses when their medical bills are substantially reduced by such insurance adjustments or write-offs.