Yes, the hospital is on the hook for the full price, and it can't tell the jury about the insurance discount. There's a special legal idea called the 'collateral source rule.' It means that if someone hurts you, they don't get a discount just because you were responsible enough to have insurance. Your insurance is meant to help you, not the person or company that caused the harm. The judge said that if anyone gets a 'windfall' (the extra money between the full bill and what insurance paid), it should be the victim's family, not the party at fault. Telling the jury about the lower payment would be unfairly prejudicial because it would tempt them to award less money than the family deserves.

Yes, the family has shown enough proof that the hospital might have messed up. Experts have to explain the important parts of a medical malpractice case, and doctors who treated Katherine can give expert opinions. She should get money based on the full bills for her medical care, not just what insurance paid, because of a rule that says money from other sources shouldn't reduce what the hospital owes. The court says it's not fair to use what insurance paid to try to pay less, because that's like cheating the rule and might make the jury give less money unfairly.

I] t cannot be seriously disputed that a treating physician's diagnoses, prognoses, or similar conclusions as to the patient's condition are `based upon scientific, technical, or other specialized knowledge,'and, as such, are outside the scope of [Federal] Rule 701-and inside the scope of [Federal] Rule 26 (a)(2)(A

As this court has observed, " `[w] hile all experts must be disclosed under Rule 26 (a)(2)(A), only "retained" experts must provide Rule 26 (a)(2)(B) reports.'"

The United States District Court for the District of New Hampshire has also expressed concern that use of the amount paid as evidence of reasonable value would be "an end-run around the collateral source rule, as a number of courts have concluded in upholding the exclusion of what a third party paid toward medical expenses as evidence of their value."

—observing that evidence of amounts paid, even if offered only to rebut reasonableness of undiscounted bills, "strikes the court as an end-run around the collateral source rule

Both parties agree, however, that "Rule 26 (a)(2)(B) reports are not required as a prerequisite to a treating physician expressing opinions as to causation, diagnosis,[and] prognosis... where they are based on the [plaintiff's] treatment," provided, as is the case with each doctor, that the witness has been properly designated as an expert under Rule 26 (a)(2)(A).

Amoskeag contends that under Rule 37 (c)(1), plaintiffs must be precluded from offering any expert testimony on these issues because their failure to provide such a disclosure was neither substantially justified nor harmless.[1

—and as permitting the defendant "to do indirectly what it cannot do directly, that is,... seeking to limit [the plaintiff's] award... by introducing evidence that payment was made by a collateral source

By our count, 22 courts in other jurisdictions that have considered one or more aspects of our colleague's approach have rejected it.

This court has repeatedly refused, however, " `to exclude evidence of the billed cost of medical services' in favor of `the amounts actually paid'in satisfaction of those costs by the plaintiff's health insurers. "

Yes. New Hampshire's collateral source rule allows a plaintiff to recover the reasonable value of medical services, which is the billed amount, and evidence of the lesser amount paid by an insurer is inadmissible. The collateral source rule dictates that any benefit from a source independent of the tortfeasor should not reduce the defendant's liability. The court reasons that the purpose of this rule is to prevent a windfall to the tortfeasor; if a windfall exists (the difference between the amount billed and the amount paid), it should benefit the injured plaintiff. The court rejected Dartmouth Hitchcock’s argument that the amount paid is better evidence of the services' value, viewing it as an 'end-run around the collateral source rule.' Applying Federal Rule of Evidence 403, the court concluded that while evidence of the amount paid has some probative value as to the reasonableness of the charges, this value is substantially outweighed by the significant risk of unfair prejudice—namely, that the jury might improperly reduce the plaintiff's damage award in violation of the collateral source rule's substantive purpose.

Yes, the plaintiffs have presented a prima facie case of medical malpractice. Expert testimony is required to prove the essential elements of a medical malpractice case, and treating physicians' opinions are considered expert testimony under Federal Rule 26(a)(2)(A). The reasonable value of medical services is the proper measure of damages, and the plaintiffs are entitled to recover the full amount billed for medical services, not just the amount paid by third-party payers, due to the collateral source rule. The court emphasizes that evidence of amounts paid by third parties is not admissible to challenge the reasonableness of the billed amounts, as it would constitute an end-run around the collateral source rule. This is because allowing such evidence carries a significant risk of unfair prejudice to the plaintiffs, as the jury may improperly reduce the damages award. The probative value of the amounts paid is substantially outweighed by this risk of prejudice.

Aumand v. Dartmouth Hitchcock Medical Center

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