Committee advances bill to let juries see billed and paid medical amounts; insurers, providers clash over effect

Senate Bill 231, a proposal by Senator Reese to allow juries and judges to consider both billed and paid amounts for medical care and to permit admission of agreements between providers and third-party payers, was debated extensively on May 13, 2025 and was reported with amendments out of the Senate Committee on Judiciary A.

Senator Reese said the bill is grounded in transparency and fairness: “Removing the blindfold from judges and juries does not disadvantage claimants. It ensures awards are grounded in reality,” he told the committee, adding he focused on two buckets of evidence—amounts already paid by health plans and billed amounts not yet paid—and sought a way to let a trier of fact evaluate reasonableness.

Business groups, including the Louisiana Association of Business and Industry (represented by Will Green), and the Farm Bureau testified in support, telling the committee that high and unpredictable medical billing drives higher jury awards and contributes to rising commercial insurance costs. Will Green said the bill would bring “fairness, certainty and transparency” and compared the measure to approaches in other states.

Opponents — including plaintiff attorneys, hospitals and medical associations — warned the change would create inequities between insured and uninsured plaintiffs, push medical providers into litigation, and could reduce access to care if payment caps (discussed in committee amendments) made treatment financially infeasible for providers. Don Caffrey, speaking for the Louisiana Orthopedic Association, warned that a 300% of Medicare cap and admission of billing contracts could “limit the ability of patients to see those orthopedic surgeons” and increase subpoenas and depositions of treating clinicians.

During the hearing Senator Luno and others expressed concern that a strict cap (described by some as 300% of the Medicare fee schedule in an amendment discussed in the hearing) would discourage providers from treating crash victims. Senator Reese and other advocates described multiple paths explored in negotiations, including pretrial discovery, judge-managed reasonableness hearings, and limiting recoveries in certain circumstances. The committee adopted an amendment (amendment set 16 13) that integrated several caps and discovery requirements discussed in the hearing: limiting certain recoveries to 30% (language retained from prior drafts), referencing a 300% of Medicare trigger for further justification, and requiring discovery of payments and agreements before trial. The amendment also sought to exclude medical malpractice and workers’ compensation claims from the measure and included language derived from prior Hoffman-related codification about attorney-negotiated write-offs.

Commercial and towing industry witnesses said unpredictable awards and rising premiums had forced some small businesses to reduce operations or close. Jessica Herring, who testified for tow operators in Vernon Parish, said her company’s commercial insurance had increased from about $3,800 in 2018 to nearly $14,000 in 2024 and that the rise in premiums threatens small operators.

Plaintiff-side witnesses, including Luke Williams of the Louisiana Association of Justice and attorneys who represent injured residents, argued that the bill disadvantages those who buy insurance because it uses their negotiated discounts to reduce a wrongdoer’s liability; Williams said the change could create “tremendous inequity” between insured and uninsured claimants. He added that experience after prior collateral-source changes did not produce meaningful premium reductions.

The committee adopted the sponsor’s amendment and then voted to report the bill with amendments. The roll-call recorded a majority in favor, and the bill was reported with amendments for further consideration. The transcript shows broad agreement among committee members that the topic requires further work: senators and stakeholders repeatedly asked for additional negotiation on thresholds, discovery procedures, how to treat contractual discounts, and protections for providers in rural areas.

The record separates discussion (cost drivers, coverage disparities, provider access) from direction (adopted amendment with numeric triggers and discovery requirements) and action (committee vote to report SB 231 with amendments). The committee placed dozens of written cards in the record: the transcript records dozens of green cards in support and dozens in opposition who did not speak, and several witnesses provided live testimony on both sides.

Next steps: the bill proceeds from committee with amendments. Sponsors and stakeholders signaled a continued negotiation phase on caps, discovery, and implementation language before any final floor action.