Strategies, Challenges, and Answers

Nevada Kicks The Can Down The Road On The “Billed Vs. Paid” Issue

Billed vs. PaidPlaintiffs often hope to recover a medical provider’s higher “billed” rate, even though the same medical provider accepts in full satisfaction a lesser “paid” amount from an insurance company.  We noted HERE that some states have either refused to allow evidence of the higher “billed” amount or have allowed rebuttal evidence that the doctor accepted the lower “paid” amount in satisfaction of the bill.

As reported HERE, the Nevada Supreme Court case of Tri-County Equip. & Leasing, LLC., v. Klinke set the stage for Nevada to decide whether it would follow the precedent setting cases in California, Howell v. Hamilton Meats & Provisions, Inc., 52 Cal. 4th 541, 257, P.3d 81, 128 Cal Rptr. 3d 658 (2011) and Texas Haygood v. Escabedo, Slip Op. No. 09-0377 (Tex. Sup. Ct. July 1, 2011).

The Nevada Supreme Court published its opinion, Tri-County Equip. & Leasing, LLC., v. Klinke, 128 Nev.Adv.Op. 33 (2012), but left undecided the question of whether evidence of the “write downs” was admissible.  In its opinion, the Court pointed out that Klinke had received medical treatment through the California worker’s compensation system.  In Nevada worker’s compensation cases, evidence of the “paid” amount is admissible per statute.  NRS 616C.215(10).  The Court determined under conflict of laws principals that Nevada law should apply, treating California worker’s compensation payments the same as a Nevada worker’s compensation payment.  The “paid” amount was the amount that should have been admitted.  However, the Court specifically refused to provide a rule applicable to non-worker’s compensation cases.

In light of that fact, Nevada attorneys who want to challenge the higher “billed” rate will have to assert that argument on the record at a non-worker’s compensation trial and then appeal it to the Court.  In addition, litigators may want to try and mitigate the effects of the higher “billed” rate by following some of our suggestions HERE.

If you have questions on how to address this issue, please feel free to contact Mike at Mills & Associates, 702-240-6060 x114 and discuss it with him.

About Michael Mills

Mr. Mills practices in the area of civil litigation and appeals, with particular experience in matters involving trucking liability, insurance defense, insurance coverage, premises liability, products liability and defense of personal injury. Mr. Mills is a member of the Trucking Insurance Defense Association, the Defense Research Institute Trucking Committee and the Nevada Motor Transport Association. Mr. Mills is licensed to practice before the Nevada Supreme Court and the Utah Supreme Court. He is also licensed to appear before the United States Supreme Court, the U.S. District Courts for the Districts of Nevada and Utah, as well as the U.S. Court of Appeals for the Ninth Circuit. Mr. Mills has created 3 Blogs for the benefit of the insurance industry. He serves as editor and publisher of the Nevada Insurance Law Blog, the Nevada Coverage and Bad Faith Blog and the Nevada Trucking Law Blog.

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