Past
and Future Medical Expenses
Past and future
medical expenses are the only
items of damages upon which
the Louisiana Medical Malpractice
Act does not place a cap. However,
there are some specific laws
which address the procedure
for payment of these medical
expenses.
Louisiana law
places a cap of $500,000 on
all items of damages in a medical
malpractice suit except past
and future medical expenses.
If a patient goes to trial and
wins, the Louisiana Patient's
Compensation Fund (the "PCF")
must pay for the past and future
medical expenses above and beyond
the cap of $500,000.
If a verdict is
rendered in favor of the patient
at trial for an amount of total
damages which is less than $500,000,
then the PCF must pay the entirety
of the judgment, plus interest,
in one lump sum to the patient.
However, if the verdict exceeds
$500,000 in total damages, then
the PCF is allowed to pay for
the future medical expenses
as they are incurred by the
patient.
Ironically, the
law allows the jury to answer
the question as to whether the
patient is in need of future
medical care (assuming the patient
won on liability), and the amount
which will be awarded for that
future care. However, the patient
does not get that amount. The
patient who wins gets to have
their future medical expenses
paid as they are incurred.
The PCF sets up
an account by which the patient's
health care providers submit
the bills for the medical care
directly to them. If the PCF
finds the bill to be reasonable
and in order they pay it. If
not, they will refuse to pay
it. The patient's only remedy
at that point is to go back
to their lawyer and to court
to seek an order to force the
PCF to pay the bill.
The PCF reportedly
pays out approximately $1,000,000
per month in medical expenses
to patients who have been the
victim of medical malpractice.
Thus, it is not difficult to
imagine that they are always
seeking to limit their exposure
for payment of more medical
expenses.
The PCF has also
adopted rules that limit their
exposure for paying for around
the clock custodial care of
patients that require such care.
This has not been fully litigated
to date and thus some controversy
surrounds this issue.
In rare instances,
and in an attempt to limit their
future exposure for payment
of future medical expenses,
the PCF has negotiated a lump
sum payment of medical expenses
at a very discounted rate. If
the patient has private insurance
or medicare or medicaid paying
their medical expenses, then
they can invest a lump sum settlement
to greatly enhance the quality
of their future care. This is
usually only seen in catastrophic
injury cases like birth, brain
injuries or paraplegics.
