For rideshare automobile accidents occurring on or after January 1, 2027, California Senate Bill 623 (SB 623) establishes new limits on the recovery of certain past medical expenses from lien-based providers. Along with these limits, the law introduces requirements governing medical lien transfers, attorney-provider financial relationships, and related disclosures.
Together, these changes may affect how personal injury attorneys evaluate SB 623 rideshare claims at intake, particularly when a prospective client may rely on lien-based medical care.
Before SB 623: California’s Rules for Lien-Based Medical Damages
Before SB 623, California law did not impose a fixed statutory ceiling specifically on lien-based past medical damages. Recovery instead turned on the plaintiff’s liability for the expense and the reasonable value of the medical services provided.
Medical bills could be relevant, but the amount billed alone did not establish reasonable value.
After SB 623: New Limits on Lien-Based Medical Damages
SB 623 added Civil Code § 3333.9, which limits the recovery of certain past medical expense damages involving lien-based providers in covered rideshare automobile cases. Under the new section, recoverable damages for covered lien-based medical expenses are limited to the lower of:
- The applicable 70th percentile of billed charges reported by FAIR Health or a comparable commercially recognized database; or
- The amount actually billed for the service.
| Before SB 623 | After SB 623 |
|---|---|
| No fixed statutory ceiling applied specifically to lien-based past medical damages. | Covered damages are capped at the applicable 70th-percentile benchmark or the amount actually billed, whichever is lower, subject to a narrow exception. |
The benchmark is based on the same or similar service in the applicable geographic area at the time of treatment and establishes a ceiling, not a presumptive award. Defendants may still challenge causation, medical necessity, reasonableness, billing, and coding.
Under Civil Code § 3333.9, any billed medical amounts exceeding the statutory cap are void and unenforceable against the plaintiff, and evidence of those excess charges is inadmissible at trial.
SB 623’s Exception for Specialized Medical Treatment
A court may permit recovery above the statutory maximum for exceptionally rare or highly specialized treatment when no reasonably comparable provider or service was available.
The claimant must:
- File a motion before trial;
- Establish the exception by clear and convincing evidence; and
- Support the request with expert testimony.
If the motion is denied, the opposing party is entitled to reasonable attorney’s fees and costs incurred in opposing it.
New Billing Documentation Requirements
Covered lien-based medical expenses must also be supported by itemized bills identifying the services provided at the applicable procedure-code level. If billing compliance is challenged in writing with reasonable specificity, the provider or party offering the bill has 30 days to cure, supplement, or clarify the documentation.
Which Medical Expenses Fall Outside SB 623’s Damages Limit?
The new damages limit applies to covered medical expenses from a “lien-based provider.” SB 623 excludes certain providers from that definition, including providers offering care through:
- Health insurance
- Government health coverage
- California’s Hospital Lien Act
These exclusions are important when determining whether the new limit applies to a plaintiff’s past medical expenses.
SB 623 Rules for Transferred Medical Liens
SB 623 defines a “medical lien” broadly to include liens, assignments, receivables, and other rights to payment tied to the proceeds of a legal claim.
When a medical lien is sold, assigned, financed, factored, or otherwise transferred:
- The transferred lien remains subject to the 70th-percentile ceiling, and recovery cannot exceed the consideration paid or payable to acquire it.
- These limits apply to both the assignee’s recovery and the amount the plaintiff may be required to pay.
- Transfer agreements and the consideration paid or payable are subject to disclosure.
The transfer of a medical receivable can therefore affect both recoverable damages and discovery obligations.
SB 623 Attorney-Provider Restrictions and Disclosures
SB 623 imposes additional restrictions and disclosure requirements involving plaintiffs’ attorneys and lien-based providers.
For covered claims:
- A contingency-fee attorney cannot refer a client to a provider in which the attorney or an immediate family member has a direct ownership interest.
- Certain fee-splitting, kickback, and referral-compensation arrangements are prohibited.
- Attorneys cannot charge an additional fee based on reducing, compromising, or resolving a medical lien.
- Certain attorney-provider financial relationships are discoverable.
- Upon request, a provider must disclose whether the patient was referred by the attorney or firm and approximately how many patients that attorney or firm referred during the preceding 24 months.
These provisions make referral and financial relationships more relevant to discovery in covered rideshare cases.
What Damages Are Not Capped by SB 623?
The statutory ceiling on covered lien-based past medical damages does not itself cap:
- Future medical expenses
- Lost earnings
- Diminished earning capacity
- Noneconomic damages
- Property damage
- Other recoverable losses
The statute therefore limits a specific component of damages rather than imposing an overall cap on rideshare injury claims.
What SB 623 Means for Plaintiffs’ Attorneys
The anticipated structure of medical treatment and payment may become more significant when evaluating SB 623 rideshare claims, particularly when a prospective client is uninsured and may rely on lien-based care.
Counsel may need to consider:
- Medical payment arrangements: Whether the client has health coverage or will rely on lien-based care.
- Damages assessment: How the new limit applies alongside other recoverable damages and available coverage.
- Lien and provider issues: Whether liens have been transferred and whether referral, financial, or disclosure requirements apply.
Lack of health insurance does not determine whether a case is viable, but SB 623 may make lien-based treatment a more important consideration during early case evaluation.
Legal Disclaimer: This article is for educational and informational purposes and does not constitute legal advice. SB 623 contains specific definitions, exceptions, effective-date provisions, and application rules that should be reviewed against the facts of an individual case.
