Fla. Stat. 768.0427
Admissibility of evidence to prove medical expenses in personal injury or wrongful death actions; disclosure of letters of protection; recovery of past and future medical expenses damages

(1)

DEFINITIONS.—As used in this section, the term:“Factoring company” means a person who purchases a health care provider’s accounts receivable at a discount below the invoice value of such accounts.“Health care coverage” means any third-party health care or disability services financing arrangement, including, but not limited to, arrangements with entities certified or authorized under federal law or under the Florida Insurance Code; state or federal health care benefit programs; workers’ compensation; and personal injury protection.“Health care provider” means any of the following professionals and entities, and professionals and entities similarly licensed in another jurisdiction:
A provider as defined in s. 408.803.
A clinical laboratory providing services in this state or services to health care providers in this state, if the clinical laboratory is certified by the Centers for Medicare and Medicaid Services under the federal Clinical Laboratory Improvement Amendments and the federal rules adopted thereunder.
A federally qualified health center as defined in 42 U.S.C. s. 1396d(l)(2)(B), as that definition existed on March 24, 2023.
A health care practitioner as defined in s. 456.001.
A health care professional licensed under part IV of chapter 468.
A home health aide as defined in s. 400.462.
A provider licensed under chapter 394 or chapter 397 and its clinical and nonclinical staff providing inpatient or outpatient services.
A continuing care facility licensed under chapter 651.
A pharmacy permitted under chapter 465.
“Letter of protection” means any arrangement by which a health care provider renders treatment in exchange for a promise of payment for the claimant’s medical expenses from any judgment or settlement of a personal injury or wrongful death action. The term includes any such arrangement, regardless of whether referred to as a letter of protection.

(a)

“Factoring company” means a person who purchases a health care provider’s accounts receivable at a discount below the invoice value of such accounts.

(b)

“Health care coverage” means any third-party health care or disability services financing arrangement, including, but not limited to, arrangements with entities certified or authorized under federal law or under the Florida Insurance Code; state or federal health care benefit programs; workers’ compensation; and personal injury protection.

(c)

“Health care provider” means any of the following professionals and entities, and professionals and entities similarly licensed in another jurisdiction:A provider as defined in s. 408.803.A clinical laboratory providing services in this state or services to health care providers in this state, if the clinical laboratory is certified by the Centers for Medicare and Medicaid Services under the federal Clinical Laboratory Improvement Amendments and the federal rules adopted thereunder.A federally qualified health center as defined in 42 U.S.C. s. 1396d(l)(2)(B), as that definition existed on March 24, 2023.A health care practitioner as defined in s. 456.001.A health care professional licensed under part IV of chapter 468.A home health aide as defined in s. 400.462.A provider licensed under chapter 394 or chapter 397 and its clinical and nonclinical staff providing inpatient or outpatient services.A continuing care facility licensed under chapter 651.A pharmacy permitted under chapter 465.
1. A provider as defined in s. 408.803.
2. A clinical laboratory providing services in this state or services to health care providers in this state, if the clinical laboratory is certified by the Centers for Medicare and Medicaid Services under the federal Clinical Laboratory Improvement Amendments and the federal rules adopted thereunder.
3. A federally qualified health center as defined in 42 U.S.C. s. 1396d(l)(2)(B), as that definition existed on March 24, 2023.
4. A health care practitioner as defined in s. 456.001.
5. A health care professional licensed under part IV of chapter 468.
6. A home health aide as defined in s. 400.462.
7. A provider licensed under chapter 394 or chapter 397 and its clinical and nonclinical staff providing inpatient or outpatient services.
8. A continuing care facility licensed under chapter 651.
9. A pharmacy permitted under chapter 465.

(d)

“Letter of protection” means any arrangement by which a health care provider renders treatment in exchange for a promise of payment for the claimant’s medical expenses from any judgment or settlement of a personal injury or wrongful death action. The term includes any such arrangement, regardless of whether referred to as a letter of protection.

(2)

ADMISSIBLE EVIDENCE OF MEDICAL TREATMENT OR SERVICE EXPENSES.—Evidence offered to prove the amount of damages for past or future medical treatment or services in a personal injury or wrongful death action is admissible as provided in this subsection.Evidence offered to prove the amount of damages for past medical treatment or services that have been satisfied is limited to evidence of the amount actually paid, regardless of the source of payment.Evidence offered to prove the amount necessary to satisfy unpaid charges for incurred medical treatment or services shall include, but is not limited to, evidence as provided in this paragraph.
If the claimant has health care coverage other than Medicare or Medicaid, evidence of the amount which such health care coverage is obligated to pay the health care provider to satisfy the charges for the claimant’s incurred medical treatment or services, plus the claimant’s share of medical expenses under the insurance contract or regulation.
If the claimant has health care coverage but obtains treatment under a letter of protection or otherwise does not submit charges for any health care provider’s medical treatment or services to health care coverage, evidence of the amount the claimant’s health care coverage would pay the health care provider to satisfy the past unpaid medical charges under the insurance contract or regulation, plus the claimant’s share of medical expenses under the insurance contract or regulation, had the claimant obtained medical services or treatment pursuant to the health care coverage.
If the claimant does not have health care coverage or has health care coverage through Medicare or Medicaid, evidence of 120 percent of the Medicare reimbursement rate in effect on the date of the claimant’s incurred medical treatment or services, or, if there is no applicable Medicare rate for a service, 170 percent of the applicable state Medicaid rate.
If the claimant obtains medical treatment or services under a letter of protection and the health care provider subsequently transfers the right to receive payment under the letter of protection to a third party, evidence of the amount the third party paid or agreed to pay the health care provider in exchange for the right to receive payment pursuant to the letter of protection.
Any evidence of reasonable amounts billed to the claimant for medically necessary treatment or medically necessary services provided to the claimant.
Evidence offered to prove the amount of damages for any future medical treatment or services the claimant will receive shall include, but is not limited to, evidence as provided in this paragraph.
If the claimant has health care coverage other than Medicare or Medicaid, or is eligible for any such health care coverage, evidence of the amount for which the future charges of health care providers could be satisfied if submitted to such health care coverage, plus the claimant’s share of medical expenses under the insurance contract or regulation.
If the claimant does not have health care coverage or has health care coverage through Medicare or Medicaid, or is eligible for such health care coverage, evidence of 120 percent of the Medicare reimbursement rate in effect at the time of trial for the medical treatment or services the claimant will receive, or, if there is no applicable Medicare rate for a service, 170 percent of the applicable state Medicaid rate.
Any evidence of reasonable future amounts to be billed to the claimant for medically necessary treatment or medically necessary services.
This subsection does not impose an affirmative duty upon any party to seek a reduction in billed charges to which the party is not contractually entitled.Individual contracts between providers and authorized commercial insurers or authorized health maintenance organizations are not subject to discovery or disclosure and are not admissible into evidence.

(a)

Evidence offered to prove the amount of damages for past medical treatment or services that have been satisfied is limited to evidence of the amount actually paid, regardless of the source of payment.

(b)

Evidence offered to prove the amount necessary to satisfy unpaid charges for incurred medical treatment or services shall include, but is not limited to, evidence as provided in this paragraph.If the claimant has health care coverage other than Medicare or Medicaid, evidence of the amount which such health care coverage is obligated to pay the health care provider to satisfy the charges for the claimant’s incurred medical treatment or services, plus the claimant’s share of medical expenses under the insurance contract or regulation.If the claimant has health care coverage but obtains treatment under a letter of protection or otherwise does not submit charges for any health care provider’s medical treatment or services to health care coverage, evidence of the amount the claimant’s health care coverage would pay the health care provider to satisfy the past unpaid medical charges under the insurance contract or regulation, plus the claimant’s share of medical expenses under the insurance contract or regulation, had the claimant obtained medical services or treatment pursuant to the health care coverage.If the claimant does not have health care coverage or has health care coverage through Medicare or Medicaid, evidence of 120 percent of the Medicare reimbursement rate in effect on the date of the claimant’s incurred medical treatment or services, or, if there is no applicable Medicare rate for a service, 170 percent of the applicable state Medicaid rate.If the claimant obtains medical treatment or services under a letter of protection and the health care provider subsequently transfers the right to receive payment under the letter of protection to a third party, evidence of the amount the third party paid or agreed to pay the health care provider in exchange for the right to receive payment pursuant to the letter of protection.Any evidence of reasonable amounts billed to the claimant for medically necessary treatment or medically necessary services provided to the claimant.
1. If the claimant has health care coverage other than Medicare or Medicaid, evidence of the amount which such health care coverage is obligated to pay the health care provider to satisfy the charges for the claimant’s incurred medical treatment or services, plus the claimant’s share of medical expenses under the insurance contract or regulation.
2. If the claimant has health care coverage but obtains treatment under a letter of protection or otherwise does not submit charges for any health care provider’s medical treatment or services to health care coverage, evidence of the amount the claimant’s health care coverage would pay the health care provider to satisfy the past unpaid medical charges under the insurance contract or regulation, plus the claimant’s share of medical expenses under the insurance contract or regulation, had the claimant obtained medical services or treatment pursuant to the health care coverage.
3. If the claimant does not have health care coverage or has health care coverage through Medicare or Medicaid, evidence of 120 percent of the Medicare reimbursement rate in effect on the date of the claimant’s incurred medical treatment or services, or, if there is no applicable Medicare rate for a service, 170 percent of the applicable state Medicaid rate.
4. If the claimant obtains medical treatment or services under a letter of protection and the health care provider subsequently transfers the right to receive payment under the letter of protection to a third party, evidence of the amount the third party paid or agreed to pay the health care provider in exchange for the right to receive payment pursuant to the letter of protection.
5. Any evidence of reasonable amounts billed to the claimant for medically necessary treatment or medically necessary services provided to the claimant.

(c)

Evidence offered to prove the amount of damages for any future medical treatment or services the claimant will receive shall include, but is not limited to, evidence as provided in this paragraph.If the claimant has health care coverage other than Medicare or Medicaid, or is eligible for any such health care coverage, evidence of the amount for which the future charges of health care providers could be satisfied if submitted to such health care coverage, plus the claimant’s share of medical expenses under the insurance contract or regulation.If the claimant does not have health care coverage or has health care coverage through Medicare or Medicaid, or is eligible for such health care coverage, evidence of 120 percent of the Medicare reimbursement rate in effect at the time of trial for the medical treatment or services the claimant will receive, or, if there is no applicable Medicare rate for a service, 170 percent of the applicable state Medicaid rate.Any evidence of reasonable future amounts to be billed to the claimant for medically necessary treatment or medically necessary services.
1. If the claimant has health care coverage other than Medicare or Medicaid, or is eligible for any such health care coverage, evidence of the amount for which the future charges of health care providers could be satisfied if submitted to such health care coverage, plus the claimant’s share of medical expenses under the insurance contract or regulation.
2. If the claimant does not have health care coverage or has health care coverage through Medicare or Medicaid, or is eligible for such health care coverage, evidence of 120 percent of the Medicare reimbursement rate in effect at the time of trial for the medical treatment or services the claimant will receive, or, if there is no applicable Medicare rate for a service, 170 percent of the applicable state Medicaid rate.
3. Any evidence of reasonable future amounts to be billed to the claimant for medically necessary treatment or medically necessary services.

(d)

This subsection does not impose an affirmative duty upon any party to seek a reduction in billed charges to which the party is not contractually entitled.

(e)

Individual contracts between providers and authorized commercial insurers or authorized health maintenance organizations are not subject to discovery or disclosure and are not admissible into evidence.

(3)

LETTERS OF PROTECTION; REQUIRED DISCLOSURES.—In a personal injury or wrongful death action, as a condition precedent to asserting any claim for medical expenses for treatment rendered under a letter of protection, the claimant must disclose:A copy of the letter of protection.All billings for the claimant’s medical expenses, which must be itemized and, to the extent applicable, coded according to:
For health care providers billing at the provider level, the American Medical Association’s Current Procedural Terminology (CPT), or the Healthcare Common Procedure Coding System (HCPCS), in effect on the date the services were rendered.
For health care providers billing at the facility level for expenses incurred in a clinical or outpatient setting, including when billing through an Ambulatory Payment Classification (APC) or Enhanced Ambulatory Patient Grouping (EAPG), the International Classification of Diseases (ICD) diagnosis code and, if applicable, the American Medical Association’s Current Procedural Terminology (CPT), in effect on the date the services were rendered.
For health care providers billing at the facility level for expenses incurred in an inpatient setting, including when billing through a Diagnosis Related Group (DRG), the International Classification of Diseases (ICD) diagnosis and procedure codes in effect on the date in which the claimant is discharged.
If the health care provider sells the accounts receivable for the claimant’s medical expenses to a factoring company or other third party:
The name of the factoring company or other third party who purchased such accounts.
The dollar amount for which the factoring company or other third party purchased such accounts, including any discount provided below the invoice amount.
Whether the claimant, at the time medical treatment was rendered, had health care coverage and, if so, the identity of such coverage.Whether the claimant was referred for treatment under a letter of protection and, if so, the identity of the person who made the referral. If the referral is made by the claimant’s attorney, disclosure of the referral is permitted, and evidence of such referral is admissible notwithstanding s. 90.502. Moreover, in such situation, the financial relationship between a law firm and a medical provider, including the number of referrals, frequency, and financial benefit obtained, is relevant to the issue of the bias of a testifying medical provider.

(a)

A copy of the letter of protection.

(b)

All billings for the claimant’s medical expenses, which must be itemized and, to the extent applicable, coded according to:For health care providers billing at the provider level, the American Medical Association’s Current Procedural Terminology (CPT), or the Healthcare Common Procedure Coding System (HCPCS), in effect on the date the services were rendered.For health care providers billing at the facility level for expenses incurred in a clinical or outpatient setting, including when billing through an Ambulatory Payment Classification (APC) or Enhanced Ambulatory Patient Grouping (EAPG), the International Classification of Diseases (ICD) diagnosis code and, if applicable, the American Medical Association’s Current Procedural Terminology (CPT), in effect on the date the services were rendered.For health care providers billing at the facility level for expenses incurred in an inpatient setting, including when billing through a Diagnosis Related Group (DRG), the International Classification of Diseases (ICD) diagnosis and procedure codes in effect on the date in which the claimant is discharged.
1. For health care providers billing at the provider level, the American Medical Association’s Current Procedural Terminology (CPT), or the Healthcare Common Procedure Coding System (HCPCS), in effect on the date the services were rendered.
2. For health care providers billing at the facility level for expenses incurred in a clinical or outpatient setting, including when billing through an Ambulatory Payment Classification (APC) or Enhanced Ambulatory Patient Grouping (EAPG), the International Classification of Diseases (ICD) diagnosis code and, if applicable, the American Medical Association’s Current Procedural Terminology (CPT), in effect on the date the services were rendered.
3. For health care providers billing at the facility level for expenses incurred in an inpatient setting, including when billing through a Diagnosis Related Group (DRG), the International Classification of Diseases (ICD) diagnosis and procedure codes in effect on the date in which the claimant is discharged.

(c)

If the health care provider sells the accounts receivable for the claimant’s medical expenses to a factoring company or other third party:The name of the factoring company or other third party who purchased such accounts.The dollar amount for which the factoring company or other third party purchased such accounts, including any discount provided below the invoice amount.
1. The name of the factoring company or other third party who purchased such accounts.
2. The dollar amount for which the factoring company or other third party purchased such accounts, including any discount provided below the invoice amount.

(d)

Whether the claimant, at the time medical treatment was rendered, had health care coverage and, if so, the identity of such coverage.

(e)

Whether the claimant was referred for treatment under a letter of protection and, if so, the identity of the person who made the referral. If the referral is made by the claimant’s attorney, disclosure of the referral is permitted, and evidence of such referral is admissible notwithstanding s. 90.502. Moreover, in such situation, the financial relationship between a law firm and a medical provider, including the number of referrals, frequency, and financial benefit obtained, is relevant to the issue of the bias of a testifying medical provider.

(4)

DAMAGES RECOVERABLE FOR MEDICAL TREATMENT OR SERVICE EXPENSES.—The damages that may be recovered by a claimant in a personal injury or wrongful death action for the reasonable and necessary cost or value of medical care rendered may not include any amount in excess of the evidence of medical treatment and services expenses admitted pursuant to subsection (2), and also may not exceed the sum of the following:Amounts actually paid by or on behalf of the claimant to a health care provider who rendered medical treatment or services;Amounts necessary to satisfy charges for medical treatment or services that are due and owing but at the time of trial are not yet satisfied; andAmounts necessary to provide for any reasonable and necessary medical treatment or services the claimant will receive in the future.

(a)

Amounts actually paid by or on behalf of the claimant to a health care provider who rendered medical treatment or services;

(b)

Amounts necessary to satisfy charges for medical treatment or services that are due and owing but at the time of trial are not yet satisfied; and

(c)

Amounts necessary to provide for any reasonable and necessary medical treatment or services the claimant will receive in the future.

Source: Section 768.0427 — Admissibility of evidence to prove medical expenses in personal injury or wrongful death actions; disclosure of letters of protection; recovery of past and future medical expenses damages, https://www.­flsenate.­gov/Laws/Statutes/2024/0768.­0427 (accessed Aug. 7, 2025).

768.07
Railroad liability for injury to employees 768.08
Liability of corporations having relief department for injury to employees 768.10
Pits and holes not to be left open 768.11
Pits and holes 768.12
Motor vehicle colliding with any animal at large on a public highway 768.13
Good Samaritan Act 768.14
Suit by state 768.16
Wrongful Death Act 768.17
Legislative intent 768.18
Definitions 768.19
Right of action 768.20
Parties 768.21
Damages 768.22
Form of verdict 768.23
Protection of minors and incompetents 768.24
Death of a survivor before judgment 768.25
Court approval of settlements 768.26
Litigation expenses 768.28
Waiver of sovereign immunity in tort actions 768.31
Contribution among tortfeasors 768.35
Continuing domestic violence 768.36
Alcohol or drug defense 768.37
Limitation on civil liability arising from long-term consumption of food and nonalcoholic beverages 768.38
Liability protections for COVID-19-related claims 768.39
Immunity for educational institutions for actions related to the COVID-19 pandemic 768.041
Release or covenant not to sue 768.042
Damages 768.043
Remittitur and additur actions arising out of operation of motor vehicles 768.075
Immunity from liability for injury to trespassers on real property 768.091
Employer liability limits 768.092
Special mobile equipment 768.093
Owner liability limits 768.095
Employer immunity from liability 768.096
Employer presumption against negligent hiring 768.098
Limitation of liability for employee leasing 768.125
Liability for injury or damage resulting from intoxication 768.128
Hazardous spills 768.135
Volunteer team physicians 768.136
Liability for canned or perishable food distributed free of charge 768.137
Definition 768.138
Interruption of electric utility service by order of law enforcement 768.139
Rescue of vulnerable person or domestic animal from a motor vehicle 768.295
Strategic Lawsuits Against Public Participation (SLAPP) prohibited 768.381
COVID-19-related claims against health care providers 768.382
Limitation of liability for certain voluntary engineering or architectural services 768.395
Roller skating rink safety 768.0415
Liability for injury to parent 768.0425
Damages in actions against contractors for injuries sustained from negligence, malfeasance, or misfeasance 768.0427
Admissibility of evidence to prove medical expenses in personal injury or wrongful death actions 768.0701
Premises liability for criminal acts of third parties 768.0705
Limitation on premises liability 768.0706
Multifamily residential property safety and security 768.0755
Premises liability for transitory foreign substances in a business establishment 768.0895
Limitation of liability for employers of persons with disabilities 768.0981
Limitation on actions against insurers, prepaid limited health service organizations, health maintenance organizations, or prepaid health clinics 768.1256
Government rules defense 768.1257
State-of-the-art defense for products liability 768.1315
Good Samaritan Volunteer Firefighters’ Assistance Act 768.1325
Cardiac Arrest Survival Act 768.1326
Placement of automated external defibrillators in state buildings 768.1335
Emergency Medical Dispatch Act 768.1345
Professional malpractice 768.1355
Florida Volunteer Protection Act 768.1382
Streetlights, security lights, and other similar illumination

Current through Fall 2025

§ 768.0427. Admissibility of evidence to prove medical expenses in personal injury or wrongful death actions; disclosure of letters of protection; recovery of past & future medical expenses damages's source at flsenate​.gov