State v. Wagnon

A medical charge is considered reasonable if it is at or below the market rate for the services, drugs, or other items provided. State v. Workman, 455 P3d 566 (2019).

Defendant appealed a supplemental judgment that imposed criminal restitution after being found guilty of assault in the fourth degree when he punched the victim, J, in the face. The trial court ordered Defendant to pay restitution for J's medical copays, as well as lost wages.  On appeal, Defendant argued the trial court erred in awarding damages for J's medical copays and claimed the reasonableness standard for medical expenses should also apply to copays. Further, Defendant contended that there was no testimony about the market rate for copays or testimony that the copay was reasonable. In response, the State argued the evidence on record established that copays paid in the contracted amount for J's health insurance, was sufficient to support a finding that the copays were reasonable. A medical charge is considered reasonable if it is at or below the market rate for the services, drugs, or other items provided.  State v. Workman, 455 P3d 566 (2019). The Court reasoned there was sufficient evidence because there was a breakdown of the date, medical provider, amount of each copay, as well as testimony that J's insurance provider set the amount of the copays at a flat rate based on the plan's benefits, and that the rate was derived from an arms-length transaction between the insurance company and employer.  Affirmed