First Quarter 2020


By: Peter Leritz


A Hennessy & Roach, P.C., seven state Liability Group analysis on the question of Collateral Source Issues related to Medical Bills, specifically, what is admissible before the jury?



The Missouri Legislature has long codified the Collateral Source Rule at RSMo Section 490.715.  This Rule prohibits the admission of evidence that a Plaintiff’s damages will be covered, in whole or in part, by a Plaintiff’s insurance or other source.  Traditionally this meant that the jury would only hear the amounts of the medical expenses charged to the Plaintiff by the medical care provider and not the adjusted amount actually paid by an insurer.

In recent years, the Legislature has made several amendments to Section 490.715 with the goal of prohibiting introduction of the larger charged amount and allowing only the smaller adjusted amount.  Most recently, in 2017, the statute was amended to allow the introduction of evidence of “the actual cost” of the medical care rendered to the Plaintiff.

In the case of Brancati v. Bistate Development Agency, 571 SW 3d 625 (Mo. App. ED 2018), the Eastern District ruled that the 2017 amendment did not prohibit the introduction of the original charged amounts but only allowed for the introduction of the actual paid amounts.  The Court of Appeals upheld the trial court’s decision to allow the parties to introduce evidence of both the amount billed and the amount paid.

The Supreme Court of Missouri has not ruled upon the 2017 amendments, but it denied an Application for Transfer of the Brancati ruling.  The Legislature is expected to continue to amend Section 490.715 to try to restrict the introduction of the higher charged amounts into evidence, but for the time being the Courts in Missouri are likely to follow the Brancati ruling and allow the jury to hear evidence of both the amounts originally charged by healthcare providers and the amount actually paid to satisfy the charges.