HB 1647 would tighten collateral source rules and align jury awards more closely with what providers are actually paid

Regulatory

By Kenneth Araullo

Dec 03, 2025Share

Missouri lawmakers are weighing changes to how courts handle insurance recoveries and medical damages evidence in civil cases, with a new bill aimed at limiting double recovery and clarifying what juries can see on medical costs.

House Bill 1647 would prohibit plaintiffs from effectively collecting twice for the same loss when both an insurer and a defendant contribute to payment. Under the proposal, if a plaintiff’s insurer is reimbursed by a defendant for any part of a deductible or damages already paid, that amount would be deducted from any subsequent settlement or award.

The bill also targets Missouri’s collateral source rules, which restrict the use of evidence showing what was actually paid for a plaintiff’s medical care after discounts, write-offs and other reductions.

Current statutes generally presume that the value of medical treatment equals the financial obligation owed to the provider, though parties can ask the court to consider additional evidence outside the jury’s presence.

Under existing law, if the court agrees to revisit the valuation of medical treatment, it can look at medical bills, the amounts actually paid and the portion of bills that remain outstanding or may be recoverable. That assessment occurs in a separate proceeding and is not automatically reflected in what jurors see when determining damages.

Read more:Missouri passes bill allowing qualified organizations to offer healthcare benefit plans

If HB 1647 is enacted, evidence detailing the “actual cost of care” would be admissible more directly. The bill defines actual cost as the sum of what was actually paid plus any remaining balance owed to the provider after contractual discounts, price reductions and write-offs.

Rep. Matthew Overcast (pictured above), a Republican from District 155 and HB 1647’s sponsor, said his bill is intended to resolve uncertainty in how overlapping insurance payments and subrogation are treated. He said current practice can create inconsistent outcomes and expose defendants and insurers to duplicate payments on the same claim.

“Missourians should absolutely be made whole, and this bill protects that,” Overcast said in an email. At the same time, “no-one should collect twice for the same harm, because those unnecessary costs ripple through the entire system and ultimately increase premiums for every policyholder in the state.”

Alternative benefit arrangements in Missouri

The proposal comes amid a broader period of insurance-related lawmaking in Jefferson City, where legislators are also debating how alternative benefit arrangements are presented to consumers.

Earlier this year, Senate Bill 79 cleared the state Senate; the measure would let qualified organizations offer healthcare benefit plans that are not ACA-compliant insurance as part of wider efforts to reshape healthcare access and strengthen the state’s review of health coverage pricing.

SB 79 would require those organizations to include clear notices that the contracts “are not health insurance,” may provide fewer benefits than ACA-compliant plans and can exclude preexisting conditions.

Market observers say these disclosure rules, alongside evidentiary changes proposed in HB 1647, reflect a trend toward more explicit statutory guidance on what information courts, regulators and consumers can rely on when assessing coverage and cost.

Overcast said that aligning recoveries more closely with the actual cost of medical care could support “fairer, more consistent outcomes” and contribute to a more predictable insurance environment for Missouri consumers and carriers. HB 1647 is expected to move through committee review before any potential floor vote.

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