Navigating Florida’s HB 837: Why Medical Billing Expert Witnesses Matter More Than Ever

Navigating Florida’s HB 837: Why Medical Billing Expert Witnesses Matter More Than Ever

Florida’s tort reform law, House Bill 837 (HB 837), has reshaped the way medical damages are presented in personal injury cases—and attorneys across the state are still sorting through what that really means in practice. While the statute took effect back in March 2023, new questions continue to surface about what evidence must be shown, what can be excluded, and how juries are supposed to interpret it all.

At the heart of this reform lies one complex issue: what is the “reasonable value” of medical care? Is it what was billed? What an insurer might have paid? Or something else entirely?

Let’s break down how HB 837 works when it comes to medical damages—and why working with a qualified Florida medical billing expert witness, such as those at Abacus Analytics, is quickly becoming essential to navigating this shifting legal landscape.

What HB 837 Actually Says About Medical Damages

HB 837 limits the kind of evidence plaintiffs can use to show the cost of past and future medical treatment. The goal? To cut down on what some view as inflated jury awards.

Here’s how it breaks down:

• For past medical expenses already paid, the plaintiff can only show the amount actually paid—not the full bill, and not what was originally charged.
• For past unpaid bills or future medical expenses, it depends on the plaintiff’s insurance status at the time of treatment:
  • Insured and used insurance: You can show what the insurer agreed to pay (the contract rate).
  • Insured but didn’t use insurance: You’re stuck showing what would have been paid under that plan, including out-of-pocket costs.
  • Uninsured or Medicare/Medicaid patients: You can only present 120% of the applicable Medicare rate (or 170% of Medicaid if there’s no Medicare rate).
  • Treatment under a Letter of Protection or sold to a funder: Only the amount the third party paid for the medical debt can be shown.
  • Other evidence of reasonableness: This is where things get interesting. The law also says you can present any other reasonable amounts billed, which opens the door to usual, customary, and reasonable (UCR) charges.

Sounds simple on paper, but in courtrooms across Florida, it’s anything but.

“Shall Include, But Not Limited To” – A Source of Ongoing Confusion

One of the most debated phrases in the statute is the line that the evidence “shall include, but is not limited to” these benchmarks. Does that mean plaintiffs are required to bring in 120% of Medicare? Or are they allowed to use it—but not obligated?

Some judges are interpreting it strictly, saying plaintiffs must present the benchmark rates if they want to recover for unpaid or future care. Others believe it simply expands the types of evidence that are allowed—but doesn’t mandate any particular one.

Here’s what that looks like in practice:

• In some courts, plaintiffs must proactively include Medicare-based rates to survive motions in limine or dispositive motions.
• In others, plaintiffs can present full bill charges, so long as a medical billing expert can explain why they are reasonable.

The Florida appellate courts haven’t issued consistent rulings on this yet, and until they do, trial court outcomes will likely continue to vary depending on the judge and jurisdiction.

Can HB 837 Apply to Old Cases?

That question came up quickly after the law passed—and it didn’t take long for the courts to respond. In Wolf v. Williams (Fla. 5th DCA, Nov. 2024), the court clarified that HB 837’s evidentiary rules do not apply retroactively to cases filed before March 24, 2023.

Still, some defense lawyers have argued otherwise, and there are reports of trial courts making conflicting rulings. The bottom line? Until the Florida Supreme Court weighs in, there’s uncertainty—and that means preparing for every possible scenario.

Why Medical Billing Expert Witnesses Are Now Essential

In this new legal environment, presenting medical damages isn’t just about showing a stack of bills. It’s about making the case that those charges are reasonable—a far more technical argument than it used to be.

That’s where medical billing expert witnesses come in.

1. Helping Juries Understand the Gap Between Charges and Payments

It’s common for hospitals to charge $100,000 for a surgery that Medicare would reimburse at $20,000. Without context, a jury might assume the billed amount is a rip-off or the Medicare rate is gospel. A qualified expert explains how provider charge rates are set, why payors negotiate deep discounts, and how government rates are often below actual cost.

An expert can also help jurors understand that 120% of Medicare isn’t always reflective of a market rate—especially in high-cost specialties or under letters of protection.

2. Establishing UCR Values to Support Full Bills

The statute still allows plaintiffs to present “other evidence of reasonableness,” and that’s where Usual, Customary, and Reasonable (UCR) rates come in. These are based on what similar providers charge for the same services in the same area—not what Medicare or Florida Blue thinks should be paid.

At Abacus Analytics, our medical billing experts rely on nationwide databases and chargemaster data to analyze whether the full charges align with local market rates. If a charge is above average, we’ll say so. But if it’s within range, our expert will support it—and explain why it’s fair.

3. Decoding Insurance Contracts and Letters of Protection

HB 837 also requires disclosure of detailed billing data—CPT codes, ICD codes, whether the bill was factored, and more. An expert witness with a background in medical billing can help attorneys assemble, analyze, and explain this evidence. That can be critical when trying to comply with discovery obligations or when facing a Daubert or Frye challenge.

Final Thoughts: Winning Under HB 837 Means Adapting Your Strategy

The rules have changed, and so must the strategy. Under HB 837, personal injury lawyers can’t rely on juries to simply accept a list of charges as-is. Now, more than ever, every number must be backed by evidence, context, and explanation.

That’s why bringing in a Florida medical billing expert witness early in your case is no longer a luxury—it’s a necessity. At Abacus Analytics, our experts help law firms build a clear, defensible narrative about the value of medical services. We don’t just say what something costs—we show why it’s reasonable.

Until the appellate courts settle the open questions, it’s wise to prepare for both interpretations of HB 837. That means disclosing the benchmarks, explaining the context, and preparing for a judge who may lean one way or the other.

In short? The rules of the game have changed. But with the right evidence and the right experts, you can still win.