Georgia hearing spotlights fight over 'phantom damages' and medical-billing language in Senate Bill 68

A Georgia House subcommittee heard hours of testimony for and against Section 7 of Senate Bill 68 on medical-billing disclosure and so-called "phantom damages," with hospitals, physicians and plaintiff attorneys warning the change would reduce access to care while business groups and insurers said it would curb inflated awards.

The bill’s medical-billing language would let juries see the amounts billed and the amounts actually paid or payable, supporters said. Opponents said that change would let tort defendants and juries treat the contractual discounts purchasers secure through insurance as the plaintiff’s true loss.

Why it matters: Section 7 would alter long-standing evidentiary practice about collateral-source information — what juries can learn about insurance payments or contractual write-downs. Witnesses said the change could shift settlement leverage, affect hospitals’ recovery, and influence whether specialists accept certain patients.

Providers and hospitals argued the current practice lets injured patients secure care and pursue recovery. Gordon Terry, chief executive officer of Integrity Spine and Orthopedics, warned of what he said were real-world consequences seen in Florida after similar changes. "You can't limit physicians on what they get paid," Terry said, urging the committee to "strike lines 359 through 375 in its entirety." He said limiting what providers receive in personal-injury cases led many specialists to stop treating injured patients in Florida.

Insurance and business witnesses countered that inflated billed charges — the large "blue" numbers juries see — are routinely far above what providers actually receive and can lead to outsized pain-and-suffering awards. Josh Carroll, a Macon lawyer who practices against ERISA plans, said juries should not be insulated from the reality that patients and insurers negotiate rates: "We have paid over $62,000 in health insurance premiums," Carroll said in a hypothetical aimed at showing how a tortfeasor could improperly receive the benefit of a plaintiff's negotiated rate if the process is opaque.

Plaintiff-side providers described how they use letters of protection and other arrangements to treat injured patients before settlements. An audiologist who treats mild traumatic brain injury said the practice keeps small specialty providers afloat while credentialing and liens resolve. "We use collateral source to be able to keep our lights on, to be able to keep treating Georgians," the audiologist testified.

Hospitals gave concrete examples of insurance and premium pressure. Deborah Moses, chief risk officer at Piedmont Healthcare, said professional-liability and malpractice costs have climbed and that in her view juries need accurate information to decide. Vicki Lewis, CEO of Coffee Regional Medical Center, described excess-coverage costs rising from "$550,000 in 2014 to $4,000,000 in 2025," and said a large jury award prompted a physician to stop practicing at her hospital.

Experts who have studied tort reform said there is not a simple, consistent link between passing tort restrictions and lower insurance rates. Alex Wetherbee, executive director of the Center for Justice and Democracy, cited long-term research showing no reliable correlation between broad tort restrictions and insurance premiums and argued the civil jury system remains capable and important.

Several witnesses raised specific legal and practical points: - ERISA and self-funded plans: Josh Carroll emphasized that ERISA plans can require repayment of amounts the plan paid, and he urged the committee to consider how plan repayment rights affect injured plaintiffs. - Medicaid, Medicare, TRICARE: Several witnesses warned that the bill’s approach could disproportionately harm low-income patients or those on public programs, because many treatments are not covered by those programs and would be effectively "zeroed out" before a jury saw future medical costs. - Collection and lien dynamics: Leighton Moore, an Atlanta lawyer, described the complexity of future-care planning, Medicare/Medicaid set-asides and subrogation — facts that he said juries cannot reliably predict decades into the future.

Opponents urged a narrower fix. Multiple physician and provider witnesses asked the committee to preserve jury access to the actual amount needed to satisfy a provider's bill rather than substituting hypothetical insurance payments when no claim was filed. "When no insurance was used, he also wants to impose a new fiction," Shevin Polidore, owner of Revive Orthopedics, said of the bill. "That insurance would have paid, but that's fiction. That's not what the patients owed."

Supporters argued the bill's change would reduce opportunistic litigation tied to list prices that plaintiffs never paid. Charles Tarbutton, president of a Sandersville trucking company, said juries should weigh actual payments and that prosecutors and insurers have seen demands that far exceed reasonable economic loss. "We are asking for admissibility of the actual pay amount that sets a floor and the full billed amount that sets a ceiling," Tarbutton said.

Where it stands: The subcommittee heard extensive testimony from both sides; committee members asked many follow-up questions, particularly about how future medical care should be valued and how ERISA and Medicaid repayment rules would operate. No formal action or vote was recorded at the hearing.

What’s next: Committee members signaled they plan additional work and possible amendments. Witnesses on both sides said they were available to help craft narrower language that would limit windfalls without removing plaintiffs’ ability to show the jury what a patient actually owes or will need in future care.