Tort damages--medical provider's charges and range of payments accepted for services rendered is admissible under section 79G--Law v. Griffith, 930 N.E.2d 126 (Mass. 2010).

• Author: Blum, Matthew

The Massachusetts Legislature enacted Massachusetts General Laws chapter 233, section 79G ("Section 79G") to address the admissibility of a plaintiff's medical bills "as evidence of the fair and reasonable charge" for the services provided. (1) When Massachusetts courts examined Section 79G to determine the permitted scope of that evidence, however, they also had to consider the common law collateral source rule, which prevents a defendant from "show[ing] that a plaintiff has received other compensation for his injury from some other source." (2) In Law v. Griffith, (3) the Supreme Judicial Court of Massachusetts ("SJC") considered the admissibility of the Plaintiff's medical bills under Section 79G and the collateral source rule, where the amounts actually paid by the plaintiff or a collateral source, and accepted by the medical providers, were significantly lower than the amounts that the providers had billed. (4) The SJC held that pursuant to Section 79G, a medical provider's bill is admissible on the question of the reasonable value of medical care for the plaintiff's personal injuries, even though that bill may reflect amounts significantly higher than the amounts actually paid. (5) In addition, the court held that while evidence of the amounts actually paid to the provider is not admissible, the defendant could introduce evidence of the possibility of payments made by third parties, as well as the range of payments that the provider accepts for the types of services that the plaintiff had received. (6)

In Law v. Griffith, the plaintiff, Joanne Law, sustained injuries in an automobile accident when her vehicle was struck by another vehicle driven by the defendant, Daniel Griffith. (7) Law's injuries required surgery and physical therapy, and she subsequently filed a negligence action against Griffith in the superior court. (8) Prior to trial and pursuant to Section 79G, Law filed a notice of her intention to submit copies of her medical bills into evidence. (9) In response, Griffith filed a motion in limine to exclude those medical bills, arguing that Law had not paid the actual amounts expressed on the bills that she sought to admit. (10) The trial court allowed Griffith's motion, concluding that the bills were not relevant in proving the value of the medical services that Law had received. (11) Rather, the judge found that the appropriate measure of damages was the amount that Law's insurer had actually paid, as opposed to the amount charged. (12)

At the trial's conclusion, the jury returned a verdict in favor of Law, finding that Griffith was seventy-five percent liable for Law's injuries, awarding her $48,500.00. (13) Accounting for Law's twenty-five percent liability, the judge reduced that award by $12,125.00, and after further reductions for the amount of personal injury benefits that Law had already received, which totaled $7,818.50, the court entered judgment for Law in the amount of $28,556.50. (14) Law appealed the jury's award of damages, asserting error in the trial judge's exclusion of the medical bills. (15) The Massachusetts Appeals Court concluded that it was error to preclude Law from introducing the medical records that reflected the amount that the providers charged, and the court reversed and remanded the case to the superior court. (16) Griffith then sought further appellate review, and the SJC--agreeing with the appeals court--similarly reversed the judgment of the superior court and remanded the case for a new trial on damages. (17)

The Restatement (Second) of Torts [section] 920A (1979) ("Restatement") states that the collateral source rule provides that "[p]ayments made to or benefits conferred on the injured party from other sources are not credited against the tortfeasor's liability, although they cover all or a part of the harm for which the tortfeasor is liable." (18) Under this rule, "collateral-source benefits" received by a plaintiff do not reduce his or her recovery against the defendant. (19) The rule promotes a theory of tort deterrence by preventing a tortfeasor from benefitting from certain acts of the injured person or a third party. (20) Furthermore, the rule protects against the possibility of jury prejudice or confusion, which would likely arise if the judge admitted evidence proving the existence of such collateral sources. (21) Massachusetts recognizes the collateral source rule, and its courts have generally followed the traditional language of the rule. (22)

Nevertheless, as the Restatement points out, the collateral source rule is "of common law origin and can be changed by statute." (23) Indeed, the majority of states, including Massachusetts, have modified the traditional language of the collateral source rule through legislation. (24) For example, the Massachusetts statute creating an exception to the common law collateral source rule provides that, in medical malpractice cases, collateral source benefits may be introduced into evidence when determining awards of medical damages. (25) Furthermore, noting a common law exception, the SJC has recognized that "in some circumstances, evidence of collateral source income may be admissible, in the discretion of the trial judge, 'as probative of a relevant proposition, say ... credibility of a particular witness.'" (26) Notwithstanding the aforementioned exceptions, Massachusetts courts generally apply the common law collateral source rule as it has traditionally been interpreted. (27)

The Massachusetts Legislature enacted Section 79G in 1958 to codify the admissibility of evidence used to determine the "fair and reasonable" value of medical charges incurred by an injured plaintiff. (28) Notwithstanding Section 79G, Massachusetts courts have long recognized the right of a plaintiff to recover reasonable expenses incurred for medical treatment of injuries caused by a defendant tortfeasor. (29) Nevertheless, it was the Massachusetts case Scott v. Garfield (30) that first demonstrated the potential conflict between the collateral source rule and Section 79G. (31) In Scott, however, the SJC simply raised, but did not analyze, this potential conflict because the defendants had "made no evidentiary proffer ... that would have laid the foundation for such a challenge." (32) Nonetheless, the case recognized the significance of the conflict between the common law collateral source rule and the right of an injured plaintiff to recover his reasonable medical expenses, noting that it was a matter of great concern in many jurisdictions. (33)

In Law v. Griffith, the SJC again considered the admissibility of medical bills under Section 79G, but for the first time directly addressed its apparent conflict with the collateral source rule by analyzing the permissible scope of evidence introduced under the statute and used to determine the fair and reasonable value of medical services. (34) First, the SJC promptly answered the question concerning a medical bill's general admissibility under the statute, and found that Section 79G required the trial judge to admit the plaintiff's medical bills in evidence. (35) The SJC reasoned that the statutory language of Section 79G is "clear," and thus, the statute "must be interpreted according to the ordinary meaning of the language used." (36) Accordingly, the SJC noted that "Section 79G states unambiguously that medical bills are admissible to establish the reasonable value of services rendered." (37) Thus, the SJC held that it was error for the trial judge to rule that the plaintiff's medical bills were inadmissible. (38)

The Griffith court next addressed the conflict between Section 79G and the collateral source rule, focusing its analysis on whether evidence of the actual amounts paid to the plaintiff's medical providers was also admissible. (39) The SJC first examined the history and purpose of the collateral source rule, declaring that the common law rule has both "substantive" and "evidentiary" components, while its overall purpose is tort deterrence. (40) Next, in its attempt to balance Section 79G with the collateral source rule, the SJC--addressing the issue first raised by Justice Cordy's concurrence in Scott--questioned whether the collateral source rule should limit the types of rebuttal evidence admissible under the statute in light of the substantive, evidentiary, and tort deterrence principles of the traditional common law collateral source rule. (41) The court relied in particular on the second sentence of Section 79G, noting its "general language" authorizing the use of witness testimony or medical records, as opposed to the "very specific ... directive" framed by the first sentence of the statute. (42) Ultimately, the SJC held that a reasonable way to apply the statute, without undermining the collateral source rule, is to allow a defendant to introduce evidence of a medical provider's stated charges, as well as the range of payments that the provider accepts, for the types of services the plaintiff received. (43)

In Law v. Griffith, the SJC affirmed that a plaintiff's medical bills are admissible in evidence to determine the reasonable value of medical services. (44) Further, while the actual amounts paid to medical providers is inadmissible, the SJC stated that a defendant is permitted to elicit certain testimony concerning the amounts accepted for the types of services rendered to the plaintiff. (45) The Griffith court correctly analyzed existing statutory and common law principles and properly balanced Massachusetts's collateral source rule against Section 79G. (46) The SJC's holding neither destroys traditional common law precedent, nor undermines Section 79G or its legislative intent. (47) Moreover, Griffith demonstrates the SJC's ability to consider the realities of the modern healthcare and insurance structure, and the ever-changing relationship between that system's individual, state, and private actors. (48) Thus, the decision successfully...