United States District Court, W.D. Missouri, Western Division
is Defendant's Motion in Limine. (Doc. 60.) The parties
dispute what evidence is admissible to prove the value of
Plaintiff's past medical treatment. Defendant seeks to
exclude evidence of the full amount of Plaintiff's
medical bills at trial. Defendant argues that under Missouri
Revised Statute § 490.715, Plaintiff is limited to
presenting evidence of the amount actually paid plus any
remaining dollar amount necessary to satisfy the financial
obligation for medical treatment. Plaintiff argues that
§490.715 does not limit Plaintiff to introducing
evidence of amounts paid for medical treatment. The Court
agrees with Plaintiff.
490.715.5 currently provides:
5. (1) Except as provided in subsection 2 of this section,
parties may introduce evidence of the actual cost of the
medical care or treatment rendered to a plaintiff or a
patient whose care is at issue. Actual cost of the medical
care or treatment shall be reasonable, necessary, and a
proximate result of the negligence or fault of any party.
(2) For purposes of this subsection, the phrase “actual
cost of the medical care or treatment” shall be defined
as a sum of money not to exceed the dollar amounts paid by or
on behalf of a plaintiff or a patient whose care is at issue
plus any remaining dollar amount necessary to satisfy the
financial obligation for medical care or treatment by a
health care provider after adjustment for any contractual
discounts, price reduction, or write-off by any person or
argument that § 490.715.5 limits the introduction of
evidence regarding the value of medical treatment to the
amount actually paid is based on Eastern and Western District
of Missouri cases. See Covey v. Wal-Mart Stores East,
L.P., No. 16-1262, 2017 WL 6459811 at *4 (W.D. Mo. Dec.
18, 2017); J.B. by and through Bullock v. Missouri
Baptist Hosp. of Sullivan, No. 16-01394, 2018 WL 746302
at *2 (E.D. Mo. Feb. 7, 2018); Smith v. Toyota Motor
Corp., No. 16-24, 2018 WL 1806698, at *6 (E.D. Mo. Apr.
17, 2018); and Hensley v. Crete Carrier Corporation,
No. 16-3208, slip op. at 2-3 (W.D. Mo. Aug. 30, 2017). The
Court does not find these cases helpful because either (1)
the parties only contested which version of the statute
applied and did not contest what evidence was admissible or
(2) the court did explain the basis for its decision.
Furthermore, the Court notes that these decisions are not
binding on the Court.
further argues that by stating that a party
“may introduce evidence of the actual cost of
the medical care, ” the Missouri legislature intended
to create a “permissive mandate” and limit both
parties to introducing only evidence of amounts paid. There
do not appear to be any Missouri Supreme Court or Missouri
Court of Appeals cases on point; however, at least two
Missouri Circuit Courts have considered the issue and
concluded that the statute does not prohibit the admission of
medical bills. See Newsome v. Anesthesia Assoc. of Kansas
City, P.C., No. 1616-CV13330 (16th Cir. Ct. Mo. January
30, 2018), Bennett v. SSM Medical Group, No.
1511-CC00044 (11th Cir. Ct. Mo. Oct. 3, 2017). As both
Circuit Court opinions point out, the statute provides one
method by which the value of medical treatment
“may” be proven but nothing in the language
mandates the method of proving such value. The statute
contains no language limiting what evidence can be introduced
nor any language prohibiting the admission of specific
evidence. Further, the legislature could have precluded the
admissibility of medical bills, but did not do so. See
Bennett v. SSM Medical Group, No. 1511-CC00044 (11th
Cir. Ct. Mo. Oct. 3, 2017). Thus, Court agrees that the
statute does not preclude the introduction of medical bills
to prove the value of medical treatment.
the Court turns to common law, which provides that recovery
for medical expenses depends upon proof of the necessity and
reasonableness of the medical expenses incurred. Spica v.
McDonald, 334 S.W.2d 365, 371 (Mo. 1960) (en banc).
Although Missouri courts held that medical bills do not by
themselves prove either the necessity or reasonableness of
medical expenses, parties are permitted to introduce them if
there is evidence, such as testimony by a medical witness,
that the medical bills reflect necessary treatment and
reasonable changes. See Spica, 334 S.W.2d at 371,
Hudson v. Whiteside, 966 S.W.2d 370, 371 (Mo.Ct.App.
1998), Schaeffer v. Craden, 800 S.W.2d 165, 165-66
(Mo.Ct.App. 1990). Thus, the Court concludes that Plaintiff
is not automatically prohibited from presenting evidence of
the amounts billed. However, Plaintiff must still present
evidence that the bills reflect necessary treatment and
reasonable charges. The Court also notes that Defendant is
permitted to present evidence that the amounts billed were
not reasonable. For instance, Defendant may present evidence
of the amount Plaintiff paid. Defendant may also present
testimony on the issue.
Motion in Limine, (Doc. 60), is DENIED.
IS SO ORDERED.
 The parties agree that the 2017
version of the statute applies in this case. Thus, the Court
need not consider earlier ...