On January 1, 2026, the Louisiana Legislature fundamentally changed how damages for medical specials are evaluated. By amending Louisiana Revised Statute § 9:2800.27, the Louisiana Legislature redefined how medical write-offs, “attorney discounts” and medical funding agreements are handled in personal injury cases. Following these amendments, a plaintiff’s financial recovery should be limited to the amounts actually paid to medical providers.
Louisiana’s collateral source framework historically created a significant gap between billed medical costs and actual medical payouts. Previously, juries only reviewed the plaintiff’s gross, unadjusted medical bills, while any discounted portion of those bills was not introduced as evidence. For example, even if a medical provider billed $100,000 but only received $25,000 in payment, the jury still reviewed and calculated a potential damage award based upon the billed $100,000 amount.
Generally, the trial judge was instructed to reduce the award, after the verdict, to the actual paid rate, and then apply a discretionary penalty, up to 40% of the write-off differential, to offset the plaintiff’s costs and attorney’s fees. This system established a higher baseline for initial evaluation, which influenced settlement negotiations and the claimed value of the alleged injury.
Act 466 of the 2025 Legislative Session eliminated the post-trial hearing mechanism and repealed the 40% procurement allowance. Under the current language of La. R.S. § 9:2800.27(B), a plaintiff’s past medical expense recovery is strictly limited to the amount actually paid to the contracted healthcare provider by a health insurance issuer, Medicare, or Medicaid, along with any applicable cost-sharing liabilities like deductibles or copays. The statute now provides that juries must now be shown both the amount billed and the amount actually paid. Additionally, when counsel secures a pre-negotiated rate with a medical provider, the recovery is capped at that negotiated rate rather than the inflated “sticker price.”
It is unclear what impact these changes will have on leverage and negotiation tactics during litigation. For example, will plaintiffs shift their strategy to now include an increased medical costs projection to recoup the “billed” medicals they previously claimed under the prior rule? The answer remains unknown. However, the amendments to the collateral source rule represent a substantial shift in how personal injury damages are evaluated, to which both plaintiff and defense counsel must adjust.