Past and future medical expenses are the only items of damages upon which the Medical Malpractice Act does not place a cap. However, there are some specific laws which address the procedure for payment of these medical expenses.
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 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.