Florida Medical Bills and Letters of Protection: What Section 768.0427 Changes
Medical-expense evidence has long been a major issue in Florida personal-injury and wrongful-death litigation. Section 768.0427 now supplies detailed rules for evidence of paid bills, unpaid charges, future medical expenses, letters of protection, factoring transactions, attorney referrals, and the maximum amount recoverable as medical-expense damages.
The statute does not eliminate disputes over reasonableness, necessity, causation, coding, or future care. It changes the information that must be disclosed and the categories of evidence the parties can present. Lawyers, claimants, insurers, and healthcare providers should address those requirements when treatment begins rather than shortly before trial.
A Letter of Protection Is Defined Broadly
Section 768.0427 defines a letter of protection as any arrangement in which a healthcare provider renders treatment in exchange for a promise of payment from a judgment or settlement in a personal-injury or wrongful-death action. Fla. Stat. § 768.0427(1)(d) (2026). The definition applies regardless of the label used for the arrangement.
A provider agreement, deferred-payment letter, lien-like arrangement, or other undertaking may therefore fall within the statute even if no document is titled “Letter of Protection.” The parties should analyze the substance of the payment arrangement.
Paid Past Medical Expenses Are Limited to Amounts Actually Paid
For past medical treatment or services that have been satisfied, evidence offered to prove the amount of damages is limited to the amount actually paid, regardless of the source of payment. Fla. Stat. § 768.0427(2)(a) (2026).
That rule places importance on accurate payment histories, explanations of benefits, write-offs, adjustments, refunds, and account balances. A billed amount that was never paid and is no longer owed is treated differently from an amount actually paid or still due.
Unpaid Charges Depend on Coverage and Payment Structure
For unpaid incurred charges, the statute identifies evidence tied to the claimant's health coverage and share of expenses. If the claimant had non-Medicare or non-Medicaid coverage but treated under a letter of protection or did not submit the bill, the evidence can include what the coverage would have paid plus the claimant's contractual share. Fla. Stat. § 768.0427(2)(b)1.–2. (2026).
For a claimant without health coverage, or with Medicare or Medicaid, the statute identifies 120 percent of the applicable Medicare reimbursement rate or, if no Medicare rate applies, 170 percent of the applicable state Medicaid rate, along with other admissible evidence described by the statute. Id. § 768.0427(2)(b)3., 5.
Factoring Transactions Become Part of the Evidentiary Record
If a provider transfers the right to receive payment under a letter of protection to a factoring company or other third party, evidence may include the amount paid or agreed to be paid for that right. Fla. Stat. § 768.0427(2)(b)4. (2026).
The discount can be relevant to valuation and bias, but the legal effect depends on the complete transaction. Parties should preserve the assignment, purchase price, recourse terms, servicing arrangement, retained interests, account history, and communications about collection.
The Statute Requires Specific Letter-of-Protection Disclosures
As a condition precedent to asserting a claim for medical expenses rendered under a letter of protection, the claimant must disclose the letter, itemized and appropriately coded billings, information about any factoring transfer, available health coverage, and whether the claimant was referred for treatment under the arrangement. Fla. Stat. § 768.0427(3) (2026).
If the claimant's attorney made the referral, the statute permits disclosure of the referral notwithstanding Florida's attorney-client privilege statute. It also states that the financial relationship between the law firm and medical provider—including the number of referrals, frequency, and financial benefit—is relevant to provider bias. Id. § 768.0427(3)(e).
Future Medical Expenses Use Statutory Benchmarks
For future treatment, the statute allows evidence tied to the amount for which future charges could be satisfied through applicable health coverage plus the claimant's share. For claimants without qualifying commercial coverage, or with Medicare or Medicaid, it identifies the same 120-percent Medicare or 170-percent Medicaid framework, together with other evidence of reasonable future amounts. Fla. Stat. § 768.0427(2)(c) (2026).
A life-care plan or medical opinion must still connect the proposed treatment to the injury, establish reasonable necessity, and account for duration, frequency, inflation, and medical probability. The statute addresses amount evidence; it does not dispense with causation and necessity.
Recoverable Medical Damages Cannot Exceed the Statutory Categories
The recoverable amount for reasonable and necessary medical care may not exceed the medical-expense evidence admitted under subsection (2), and it also may not exceed the sum of amounts actually paid, amounts necessary to satisfy charges still due, and amounts necessary for reasonable future care. Fla. Stat. § 768.0427(4) (2026).
The statute also provides that individual contracts between providers and authorized commercial insurers or health maintenance organizations are not discoverable, disclosable, or admissible. Id. § 768.0427(2)(e). Parties should distinguish protected individual contracts from other discoverable billing, coverage, coding, and transaction information.
A Practical Case-Preparation Checklist
Medical-expense issues should be organized early through a detailed ledger that identifies:
Each provider, date of service, procedure code, billed amount, adjustment, payment, and current balance.
The claimant's insurance or public-benefit eligibility at the time of treatment.
Every letter of protection or equivalent payment arrangement.
Any sale, assignment, factoring, servicing, or collection transaction.
The source and circumstances of each provider referral.
The basis for future treatment, frequency, duration, and expected payment amount.
The evidence needed to address necessity, causation, reasonableness, and provider bias.
How Equity Legal Can Help
Equity Legal handles Florida injury and wrongful-death matters involving medical-expense proof, letters of protection, expert testimony, damages, insurance issues, discovery, and trial preparation. Section 768.0427 makes early billing and referral analysis an essential part of case strategy.
This article is for general informational purposes only and does not constitute legal advice. Reading it does not create an attorney-client relationship. Legal requirements can change, and application depends on the facts.
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