Short answer
For many Louisiana personal injury cases governed by the 2026 version of Louisiana Revised Statute 9:2800.27, past medical expenses paid by private health insurance, Medicare, or Medicaid are generally limited to the amount actually paid to the provider plus the patient’s deductible, copay, coinsurance, and other cost sharing. The old rule that could add 40 percent of the difference between the billed amount and the amount paid has been repealed.
That does not mean every medical expense in every case is reduced to an insurance payment. Different rules apply to unpaid bills, provider liens, workers’ compensation payments, attorney-negotiated agreements, medical malpractice claims, and automobile medical payments coverage. Future medical expenses are also a separate issue.
What changed on January 1, 2026?
Louisiana enacted Act 466 of 2025, which amended the state’s collateral-source statute effective January 1, 2026. Before the amendment, a claimant whose health insurer or Medicare paid a discounted rate could potentially receive:
- the amount actually paid to the contracted provider;
- the claimant’s applicable cost sharing; and
- an additional amount equal to 40 percent of the difference between the provider’s bill and the amount actually paid, subject to a possible reduction if the defendant proved that amount would make the award unreasonable.
Act 466 removed that additional 40 percent amount. It also changed what the factfinder may hear. In a claim involving private health insurance or Medicare payments to a contracted provider, the trier of fact is now informed of both the amount billed and the amount actually paid.
What can be recovered under the current law?
| How the bill was handled | General rule for past medical expenses |
|---|---|
| Private health insurance or Medicare paid a contracted provider | The amount actually paid to the provider, plus applicable cost sharing paid or owed by the claimant, rather than the full sticker price. |
| Medicaid paid the provider | The amount Medicaid actually paid, plus applicable cost sharing paid or owed by the claimant. |
| Workers’ compensation paid | The amount paid under the Louisiana Workers’ Compensation medical payment fee schedule. |
| Another payment arrangement applies | Amounts paid by or for the claimant and amounts still owed, including qualifying expenses secured by a contractual or statutory privilege, lien, or guarantee. |
| The claimant’s attorney made a pre-negotiated agreement for the provider to accept less than billed | The amount actually paid under that agreement, plus applicable cost sharing paid or owed by the claimant. |
The statute concerns past medical expenses. It does not eliminate separate claims that may exist for future medical care, pain and suffering, lost earnings, loss of earning capacity, disability, or other legally recoverable damages. Each category still requires proof.
A simple example of the difference
Assume a hospital billed $20,000 and accepted an $8,000 contracted payment from the patient’s health insurer, with no additional patient balance. Under the former rule, the past-medical award could include the $8,000 payment plus up to $4,800, which is 40 percent of the $12,000 difference between the bill and the payment. Under the amended rule, that additional $4,800 is gone. The recoverable amount for that bill would generally be the $8,000 actually paid, plus any applicable cost sharing the patient paid or still owes.
This is only a simplified illustration. Actual cases may involve multiple providers, deductibles, mixed payment sources, unpaid balances, liens, subrogation claims, or disputed charges.
What does the jury get to see?
For past medical expenses paid by a health insurer or Medicare to a contracted provider, Subsection E says the trier of fact must be informed of both the amounts billed and the amounts actually paid. The statutory text does not extend that specific evidence rule to every other payment category.
The billed amount can still provide context about the treatment, but it does not automatically become the amount recoverable. The court must apply the statutory limit governing the payment source.
Which cases are not covered by this statute?
Revised Statute 9:2800.27 expressly does not apply to cases brought under Louisiana’s medical malpractice statutes for qualified private or public health-care providers. It also does not apply to benefits received through automobile medical payments coverage, commonly called MedPay.
That exception is about the MedPay benefits themselves. It should not be read to mean that every part of an automobile-accident claim falls outside the statute.
Does the new rule apply to an older accident?
This requires care. Act 466 says two things: the amendments have prospective application only, and they do not apply to causes of action filed before January 1, 2026. A case filed before that date is expressly excluded. For a pre-2026 injury first filed on or after January 1, 2026, the filing language and the separate prospective-application language should both be analyzed. Until controlling appellate decisions resolve every transition issue, it is unsafe to assume that either the accident date or filing date, standing alone, answers the question in every case.
The timing issue can materially affect the recoverable medical expenses. It should be evaluated before suit and not left until settlement negotiations.
Recoverable medical expenses are not necessarily the client’s net recovery
The amount that may be claimed as damages is different from the amount a client ultimately keeps. A health plan, Medicare, Medicaid, workers’ compensation carrier, or medical provider may assert reimbursement, subrogation, or lien rights. Those interests must be identified and addressed separately. Our related guides explain who pays medical bills while a Louisiana accident claim is pending and how medical liens and subrogation claims can affect a settlement.
Frequently asked questions
Can I recover the full amount printed on a hospital bill?
Not automatically. If a health insurer, Medicare, or Medicaid paid the bill under the circumstances covered by the statute, recovery is generally tied to the amount actually paid plus applicable patient cost sharing. Other rules may apply to unpaid balances and qualifying liens or guarantees.
Does the new law erase my deductible or copay?
No. The statute defines cost sharing to include copayments, coinsurance, deductibles, and other amounts paid or owed by the claimant to the provider. Applicable cost sharing remains part of the calculation.
Does the 2026 law limit future medical expenses?
Revised Statute 9:2800.27 addresses recoverable past medical expenses. Future care is a separate damages question requiring evidence that the treatment is medically necessary, related to the injury, and reasonably likely to occur.
Should I submit accident-related treatment to my health insurer?
Do not make that decision from the face amount of a bill alone. Using available health coverage can prevent collection problems and may reduce charges, but the plan may have reimbursement rights. A lawyer can review the policy, billing status, liens, and effect on the injury claim.
Official sources
- Louisiana Revised Statute 9:2800.27
- Act 466 of the 2025 Regular Session
- Official legislative digest for Act 466
Editorial & Legal Accuracy Notice (Louisiana)
This article discusses Louisiana law and is general information, not legal advice for a particular claim. The date the lawsuit was filed, the date of the injury, the source of payment, the provider’s contracts, and any outstanding lien or reimbursement claim can change the analysis.
Questions about medical bills after a Louisiana accident?
Babcock Injury Lawyers can review the treatment charges, payment sources, filing date, liens, and insurance issues affecting a Louisiana injury claim. Call 225-500-5000 in Baton Rouge or 318-777-5000 in Ruston to request a free 48 to 72 Hour Action Plan.