The Arkansas Supreme Court issued a proposed new evidentiary rule Wednesday that would significantly limit what medical cost evidence can be presented in personal injury and medical malpractice lawsuits across the state.
The proposed Rule 412 of the Arkansas Rules of Evidence would prohibit the admission of medical costs "other than those costs actually paid by or on behalf of the plaintiff or that remain unpaid and for which the plaintiff or any third party is legally responsible" when proving the reasonable value of past necessary medical care, treatment, or services.
The court's Committee on Civil Practice developed the proposed rule in response to changes made by the Arkansas General Assembly to Arkansas Code Annotated section 16-64-120(a) through 2025 Acts of Arkansas No. 28. The legislative change prompted the court to consider how evidentiary rules should be modified to align with the new statutory framework.
Under the proposed rule, evidence of billed medical charges would be inadmissible "to the extent they represent an amount a medical provider has agreed to not accept and reduce further," according to the reporter's note accompanying the rule. Instead, only "actual medical charges, those sums required to be collected, or which have been collected" would be considered relevant evidence in determining damages.
This change could have substantial implications for personal injury litigation in Arkansas. Currently, plaintiffs often present the full amount of medical bills to establish damages, even when insurance companies or healthcare providers have negotiated significant reductions or write-offs. The practice has been criticized as allowing plaintiffs to recover damages based on artificially inflated medical costs that were never actually paid or owed.
The proposed rule defines "plaintiff" broadly as "the person who received the past necessary medical care, treatment, or services for which damages are sought," ensuring the limitation applies regardless of who technically brings the lawsuit.
Defense attorneys and insurance companies have long argued that allowing evidence of full billed amounts creates unfair windfalls for plaintiffs who receive medical care through insurance or other arrangements that result in providers accepting reduced payments. They contend that damage awards should reflect only the actual economic loss suffered, not the nominal amounts on medical bills that are routinely discounted.
Plaintiffs' attorneys, however, have traditionally argued that the full billed amount represents the reasonable value of medical services provided, regardless of payment arrangements. They maintain that allowing evidence only of amounts actually paid could unfairly penalize plaintiffs who have good insurance coverage or who benefit from provider discounts.
The proposed rule would bring Arkansas in line with a growing number of jurisdictions that have moved to limit evidence of medical costs to amounts actually paid or owed. Several other states have adopted similar restrictions through court rules or legislation, reflecting broader concerns about healthcare billing practices and their impact on civil litigation.
The Arkansas Supreme Court is now seeking public input on the proposed rule change. The comment period will remain open until April 1, 2026, giving attorneys, healthcare providers, and other interested parties nearly two months to provide feedback on the proposal.
Comments must be submitted in writing to Kyle E. Burton, Clerk of the Arkansas Supreme Court, with attention directed to "Amendments to Arkansas Rules of Civil Procedure." Written comments should be sent to the Justice Building at 625 Marshall Street, Little Rock, AR 72201. The court is also accepting electronic comments via email at rulescomments@arcourts.gov.
The court published the proposed rule in "line-in, line-out" format, showing exactly what language would be added to the Arkansas Rules of Evidence. This format allows commenters to see precisely how the new rule would read if adopted.
If ultimately adopted, Rule 412 would apply to all civil cases involving claims for past medical expenses, including personal injury lawsuits, medical malpractice cases, and other tort claims where plaintiffs seek to recover healthcare costs as damages.
The timing of the rule's implementation, should it be adopted following the comment period, remains unclear. The court typically considers all submitted comments before making final decisions on proposed rule changes, and implementation could occur later in 2026 depending on the volume and nature of feedback received.
Legal practitioners across Arkansas are expected to closely monitor the comment process, as the rule change could significantly affect litigation strategies and settlement negotiations in personal injury cases. The proposed rule represents a notable shift toward limiting recoverable damages to actual economic losses rather than nominal billing amounts that may not reflect real financial impact.