On August 13, 2009, St. Louis County Circuit Judge Stephen Goldman ruled that 490.715 RSMo. is unconstitutional and ordered that the plaintiff, who lost the underlying lawsuit, should get a new trial.  He determined that the law allows for too many different interpretations, and thus, different plaintiffs are receiving different results from different judges.  Although Judge Goldman declared the statute unconstitutional, the statute can only be stricken as unconstitutional by the Missouri Supreme Court.  Therefore, the statute still stands, but the debate will continue until the Missouri Supreme Court finally decides the issue. 

Section 490.715 RSMo. allows a judge to determine the reasonable value of the medical services received by a plaintiff, after a hearing on the matter. The amount that the judge rules is the reasonable value of the medical expenses is the amount that the plaintiff can submit to the jury. The law creates a presumption that the value of the medical services is the amount that was paid by health insurance or by the injured person.  That presumption can be overcome if the plaintiff shows that the value is actually the amount that the doctor or hospital billed, rather than what insurance paid that doctor or hospital.  Some judges rule that the reasonable value of the medical bills is always the amount paid; others rule that the reasonable value of the medical bills is the total amount billed by the doctor or hospital.  As a result, injured people are receiving different results based upon which judge is hearing their case. This is the type of law that cries out for the Missouri Supreme Court to get involved.  Hopefully, a case will come before them in the very near future, so that injured people may eventually be treated equally under this law.