Current Status of Medical Expense Evidence

Language in the decision published in West v Shelby County Healthcare, 459 S.W.3d 33 (Tenn. 2014) raised questions concerning wider application of the erosion of “sticker price” medical charges billed but never collected in tort cases. A mixed panel of the Tennessee Court of Appeals ruled in Dedmon v. Steelman, No. W2015-01462-COA-R9-CV (Tenn. Ct. App. June 2, 2016) that a hybrid approach that allows Plaintiffs to present evidence of the full, unadjusted charges billed by healthcare providers also allows Defendants to present evidence of the lower, adjusted or discounted charges that were actually paid in order to refute the excess charges claimed by Plaintiffs.


In considering the issue, the Court of Appeals concluded that under existing authority, damages in personal injury cases are not measured by ‘fixed rules of law’ but rest largely in the discretion of the trier of fact.”  Therefore, the Court ruled that Plaintiffs are entitled to present expert testimony regarding the reasonableness of their claimed damages but Defendants are permitted to offer proof contradicting the reasonableness of the medical expenses, cautioning not to run afoul of the collateral source rule by indicating how a bill was actually paid.


Both the majority decision as well as a concurring opinion of the Court of Appeals specifically asked the Supreme Court to review this case to weigh in on whether the logic of West should apply in the larger context of personal injury actions.  To date neither party has requested permission to appeal to the state Supreme Court and given the state of the record in Dedmon, it is our belief that the highest Court will not opt to consider the issue at this time with this largely undeveloped trial court record.


A corollary to the evidentiary issues clarified by Dedmon is that unredacted medical expense billings should never be withheld from properly answered written discovery.