3333.9.
(a) (1) This section applies to any civil case, claim, action, or arbitration against a network company, its subsidiary, or an app-based driver, as those terms are defined in Section 7463 of the Business and Professions Code, arising out of an automobile accident occurring on or after January 1, 2027, in which a claimant obtained medical treatment by a lien-based provider.
(2) This section shall not apply to medical services rendered, liens created, receivables assigned, or contractual rights or obligations arising before January 1, 2027.
(3) This section shall apply notwithstanding any other provision of law.
(4) Nothing in this section applies to or alters existing law except as to recovery for damages for past medical expenses from lien-based providers, and as otherwise provided by this section.
(5) Nothing in this section abrogates the collateral source rule.
(b) (1) (A) The maximum recovery of a plaintiff for damages for any medical expense for services rendered by a lien-based provider shall not exceed the 70th percentile of FAIR Health, Inc.’s billed charges, or the 70th percentile of a comparable commercially recognized billed charges database for the same or similar service in the applicable geographic area at the time the service was rendered. No plaintiff may recover past medical expense damages in excess of that amount.
(B) Nothing in this section shall be construed to establish entitlement to any particular amount for any medical service, or to preclude a defendant from challenging the amount recoverable for any medical expense.
(C) Upon motion of the plaintiff, the court may authorize recovery above the maximum recovery provided in subparagraph (A) only upon a finding, by clear and convincing evidence, and supported by expert testimony, that the service involved exceptionally rare or highly specialized treatment for which no reasonably comparable provider or service was available. Any request for recovery above the maximum recovery provided in subparagraph (A) shall be determined by the court before trial. If the court denies the motion, the party opposing the motion shall recover its reasonable attorney’s fees and costs incurred in connection with opposing the motion. Absent such a court order, the limitation provided in subparagraph (A) applies.
(D) The amount billed, charged, or claimed by a lien-based provider for past medical expenses in excess of the maximum amount recoverable under this section is void and unenforceable, and no person or entity may recover, collect, enforce, assert, seek payment of, or seek reimbursement, indemnity, contribution, or subrogation for that excess amount.
(2) No party may introduce, reference, disclose, or present to the trier of fact any billed charge, lien amount, invoice, statement, or claimed value for past medical expenses exceeding the recoverable amount pursuant to this section. Nor shall any party introduce evidence or argument or reference to this section, including, but not limited to, reference to the maximum amount. Such evidence shall be inadmissible for any purpose.
(3) Nothing in this section precludes the admission of medical bills below the maximum amount.
(4) A plaintiff shall not recover as damages for medical expenses an amount greater than the amount actually billed by the lien-based provider for that service.
(5) (A) Damages for medical expenses under this section are recoverable only if supported by itemized medical bills identifying the services provided at the procedure-code level using generally accepted health care billing and coding standards, including applicable Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD), or successor coding systems.
(B) A party challenging compliance with this paragraph shall provide written notice to the plaintiff’s attorney identifying the alleged deficiency with reasonable specificity, and the provider or party offering the bill shall have 30 days to cure, supplement, or clarify the billing records.
(c) (1) Where a medical lien, receivable, or right to payment has been sold, assigned, financed, factored, or otherwise transferred, the maximum recoverable medical expense damages, the maximum amount recoverable by the assignee, and the maximum amount for which the plaintiff may be liable shall not exceed the total consideration paid or payable in connection with the transaction to acquire the lien, receivable, or right to payment, and in no event shall exceed the maximum amount recoverable under paragraph (1) of subdivision (b).
(2) Any agreement relating to the sale, assignment, financing, factoring, or transfer of a medical lien, receivable, or right to payment, and the consideration paid or payable therefor, including any contingent, deferred, recourse-based, or future payments, shall be discoverable and shall be disclosed to the plaintiff, the plaintiff’s attorney, the defendant, the defendant’s attorney, and any applicable insurer within 30 days after the transaction and, in all events, before any settlement or distribution of settlement proceeds. No undisclosed lien sale, assignment, financing, factoring arrangement, or transfer may be asserted against a defendant, insurer, settlement, judgment, or settlement proceeds.
(3) Subject to subparagraph (B) of paragraph (5) of subdivision (b), nothing in this section shall preclude any party from challenging the reasonableness of any charge, the medical necessity of any treatment, or the accuracy of any billing, coding, or causation.
(4) Any agreement, arrangement, or transaction by which a lien-based provider transfers the economic risk of noncollection of a medical lien to a third party in exchange for immediate or deferred compensation, regardless of whether the transaction is denominated as a sale, assignment, loan, factoring arrangement, management agreement, servicing agreement, or otherwise, shall be treated as a lien assignment subject to this section.
(d) (1) Medical liens relating to the lien-based provider treatment at issue, including any assignment, financing, factoring, referral, ownership, investment, lending, or compensation between a lien-based provider and an attorney, law firm, or affiliated entity relating to the treatment, lien, or recovery shall be discoverable.
(2) Upon request, a lien-based provider shall provide a declaration under penalty of perjury stating whether the plaintiff was referred by the attorney, law firm, or any person acting on their behalf and the approximate number of patients referred by that attorney or law firm to the provider during the preceding 24 months. The declaration shall be discoverable.
(e) (1) It is unlawful for an attorney representing a plaintiff under a contingency fee agreement to refer a client to a health care provider in which the attorney or a member of the attorney’s immediate family has a direct ownership interest.
(2) It is unlawful for an attorney representing a plaintiff to fee split, receive kickbacks, rebates, or referral compensation in connection with the furnishing of lien-based provider medical treatment for that plaintiff.
(3) It is unlawful for an attorney or law firm to provide bonuses, incentives, or compensation for referrals of clients to lien-based providers for lien-based treatment.
(4) An attorney shall not charge any additional contingency fee, administrative fee, management fee, or similar fee based upon the reduction, compromise, or resolution of a medical lien. Nothing here shall prevent an attorney from retaining a third party to negotiate any lien reductions at a cost with client consent.
(5) A lien-based provider shall not enter into any agreement or understanding to reduce a medical lien before medical services are rendered. A violation of this paragraph may subject the provider to professional discipline.
(6) A violation of this subdivision may subject the attorney to professional discipline by the State Bar.
(f) The following definitions apply for purposes of this section:
(1) “Automobile accident” means any accident, collision, incident, or occurrence arising out of, resulting from, or involving the ownership, operation, maintenance, use, loading, unloading, parking, or storage of a motor vehicle.
(2) “Lien-based provider” means any health care provider or other person or entity that renders, furnishes, bills for, finances, or seeks payment for health care-related goods or services provided pursuant to an agreement under which payment is contingent upon, secured by, or expected from, the proceeds of the patient’s legal claim. The term includes any facility, hospital, ambulatory surgery center, imaging center, supplier, affiliated entity, or other person or entity participating in the course of treatment or episode of care, regardless of whether that person or entity executed a separate agreement. The term does not include providers furnishing the care pursuant to health insurance, government health coverage, or the Hospital Lien Act, as provided in Sections 3045.1 to 3045.6, inclusive.
(3) (A) “Medical lien” means any lien, assignment, receivable, right to payment, letter of protection, financing arrangement, factoring arrangement, purchase agreement, or other claim or encumbrance arising from or relating to medical goods or services furnished to a plaintiff or claimant for which payment is contingent upon, secured by, expected from, or recoverable from the proceeds of a legal claim.
(B) “Medical lien” does not include any lien, reimbursement claim, or subrogation right asserted by a private health insurer, Employee Retirement Income Security Act (ERISA) plan, workers’ compensation carrier, Medicare, Medi-Cal, TRICARE, or any other federal or state health benefit program.
(g) The Legislature declares that the provisions of this section are severable. If any provision of this section, or its application to any person or circumstance, is held invalid or unenforceable, the remaining provisions shall remain in full force and effect to the maximum extent permitted by law. It is the intent of the Legislature that each provision of this section would have been adopted independently of any other provision.