Fair and Reasonable Value

What is an appropriate measure of compensatory damages, and fair and reasonable liability, in a medical malpractice case when Medicare has helped pay for the services rendered? If Medicare will only pay $12,000 for services that would have cost upwards of $100,000, is the plaintiff entitled to $12,000 or to the $100,000? A recent case on appeal before the Supreme Court of Pennsylvania addressed this very issue. Claims professionals may be interested in the findings of the court. At issue in Jaynet A. Moorhead v. Crozer Chester Medical Center, No. 184 N.D. Appeal Docket 1998, was the definition of “reasonable value,” and whether an injured party may recover from the tort-feasor damages greater than the amount that the plaintiff had actually paid for medical care, or for which he or she incurred liability.