By: Elizabeth Richards, Esq., CEO, Altum Healthcare Solutions
Altum Healthcare Solutions is closely monitoring the major Georgia Tort Reform Bill, Senate Bill 68. Altum was in attendance last Friday as the Senate passed the bill. While the legislation promises to benefit Georgia hospitals by lowering malpractice premiums, expanding insurance options, and enhancing the state’s ability to recruit healthcare providers, evolving language within the bill may negatively impact hospital reimbursement in tort cases where they provided life-saving treatment to the injured party.
Concerns have been raised about the potential impact of tort reform on the value of verdicts hospitals rely on for reimbursement. While these concerns remain conjecture, data from Florida—where a similar bill was passed—indicates that tort settlements have been trending significantly lower than in previous years. Georgia already faces challenges with the state’s minimum insurance limits set at $25,000. A further reduction in the few settlements where funds are available could have a significant negative impact on hospitals’ third-party liability revenue.
One area of immediate concern arises from an amendment approved by the Georgia Senate on Friday, just before the bill’s passage. This amendment altered the language in the so-called “collateral source” section of the statute, specifically the newly codified provision on Medical Damages (O.C.G.A. § 51-12-1.1), in a way that creates significant issues for hospitals.
In the bill’s original version, the statute read, “special damages for medical and healthcare expenses shall be limited to the expenses of medically necessary care, treatment or services” and then goes on to define how that number will be determined if the patient has insurance. However, the amended version of the bill passed on Friday now reads, “special damages for medical and healthcare expenses shall be limited to the reasonable value of medical necessary care, treatment or services.”
This seemingly subtle change—adding “reasonable value”—fundamentally shifts how damages are determined. It places the valuation process in the hands of the patient, the insurance company, and/or a jury, while binding the hospital to that determination without its involvement. The hospital would have no role in the valuation process until after the claim is settled, at which point it would be bound by a number it had no part in determining.
The healthcare industry has already faced significant challenges in defining “reasonable value,” most notably under the No Surprises Act, where many hospitals are currently entangled in the Alternative Dispute Resolution (ADR) system over similar valuation disputes. Under this bill, however, hospitals would not even have access to an ADR process. Instead, the patient, the insurer, or a jury would unilaterally assign a “reasonable value” to the services provided, which the hospital’s lien would then attach to—yet hospitals would have no ability to contest or appeal the valuation. This change could have far-reaching financial consequences for healthcare providers, making reimbursement even more uncertain and further straining hospital resources.
Hospitals across Georgia have valid reasons to support tort reform, but the risks embedded in this bill’s language cannot be overlooked. Beneath the promise of broader reforms lies a critical threat to hospital reimbursement—one that could undermine the financial stability of providers delivering life-saving care through the state’s already strained trauma network, and that cannot be ignored.
Have further questions about Tort Reform or Hospital Liens? Reach out to info@altumhs.com. The Altum Team brings over 20 years of direct experience in healthcare law and reimbursement and is always ready to zealously advocate for hospitals, ensuring they receive the reimbursement they deserve.
