Background
The Arkansas Supreme Court’s Committee on Civil Practice proposed the creation of Rule 412 of the Arkansas Rules of Evidence to address what evidence of medical costs is admissible in civil litigation. The proposal was published for public comment following a prior per curiam order, 2026 Ark. 18, that announced the recommendation. The rule addresses a recurring issue in personal injury cases: whether plaintiffs may introduce the full “sticker price” of medical bills rather than the amounts actually paid or legally owed after insurance write-downs and negotiated adjustments.
The impetus for the rule reflects a nationwide debate over the collateral source rule and the admissibility of inflated list prices for medical services — amounts that are frequently billed but never actually collected by providers. Arkansas courts had grappled with how to handle the gap between billed charges and the amounts accepted as payment in full by healthcare providers and insurers.
The Court’s Holding
The Arkansas Supreme Court adopted new Rule 412 of the Arkansas Rules of Evidence, effective June 4, 2026. Under the rule, evidence of medical costs is admissible to prove the reasonable value of past necessary medical care only if those costs were actually paid — by the plaintiff or on the plaintiff’s behalf — or if the costs remain unpaid and the plaintiff or a third party is legally obligated to pay them.
The rule expressly excludes from evidence any medical costs that a provider or insurance carrier has agreed not to collect. The Reporter’s Note clarifies that amounts subject to contractual write-downs or write-offs — i.e., sums the provider has agreed to forgo — are inadmissible, while amounts actually required to be paid remain relevant. Justice Webb did not participate in the decision.
Key Takeaways
- Medical cost evidence is now limited to amounts actually paid or legally owed; inflated list prices that were written off or never collected are inadmissible.
- The rule applies to both paid bills (by plaintiff or a third party) and unpaid bills where a legal obligation to pay still exists.
- “Plaintiff” is defined as the person who received the medical care for which damages are sought, not necessarily the named party.
- Negotiated write-downs and amounts a provider or insurer agreed not to collect are explicitly excluded from evidence.
Why It Matters
New Rule 412 will significantly affect the calculation of past medical damages in Arkansas personal injury and tort cases. By barring evidence of billed-but-never-collected charges, the rule closes the gap between inflated list prices and the amounts actually at stake economically, likely reducing jury awards tied to unrealistically high medical bills. Defense counsel will now have a clear evidentiary basis to exclude write-off amounts, while plaintiffs’ attorneys will need to focus damages presentations on documented payment obligations.
The rule aligns Arkansas with a growing number of states that have moved to limit medical damage evidence to paid or legally owed amounts, reflecting a broader trend toward tethering tort recovery to real-world economic loss rather than phantom billing figures. Practitioners handling personal injury, medical malpractice, or any claim involving past medical expenses should update discovery practices and damages disclosures to conform to the new rule immediately, as it is effective as of the date of the opinion.