## Facts

- Tommy Bozeman suffered severe injuries in a 1993 single-vehicle accident on a Louisiana highway and received extensive medical care, including hospitalization and long-term care until his death in 1996.
- Bozeman was a Medicaid recipient; Medicaid paid approved amounts for his care.
- Pursuant to Medicaid rules, providers accepted Medicaid payments as full payment and wrote off the remaining billed balances that they were prohibited from collecting from Bozeman.
- Bozeman’s widow, on behalf of his estate, sued the State of Louisiana through the Department of Transportation and Development (DOTD), alleging an unreasonably dangerous highway condition caused the accident.

## Issues

1. Whether the collateral source rule permits a Medicaid recipient to recover, as past medical-expense damages, amounts written off by providers under Medicaid regulations when neither the plaintiff nor Medicaid paid those amounts and the plaintiff was not liable for them.

## Decision

- The Louisiana Supreme Court held that Medicaid recipients may not recover provider “write-off” amounts as damages.
- The court affirmed the State’s partial liability and left other damage determinations intact.
- The court reduced the medical-expense award to amounts actually paid by Medicaid (and any other sums actually incurred or owed), excluding written-off balances.

## Legal Principles

- The collateral source rule generally bars a tortfeasor from reducing liability because the plaintiff received compensation from an independent source.
- Application of the collateral source rule depends on whether the plaintiff provided consideration for the collateral benefit (such as premiums, employment services, or other value), reflecting a loss of patrimony tied to obtaining the benefit.
- Medicaid payments and associated provider write-offs, when the recipient provided no consideration and is not legally responsible for the written-off balances, do not represent an economic loss recoverable as tort damages.
- Past medical-expense damages for a Medicaid recipient are limited to amounts actually paid (and any amounts for which the plaintiff remains legally liable), not the full billed charges later written off.

## Conclusion

The court limited recoverable past medical expenses for a Medicaid recipient to amounts actually paid or legally owed, holding that the collateral source rule does not allow recovery of Medicaid-related provider write-offs because the plaintiff neither paid for the benefit nor incurred liability for the written-off sums.


Bozeman v. State, 879 So. 2d 692 (La. 2004)