State v. Campbell, 438 P.3d 448

Defendant stabbed the victim, who required emergency surgery and two weeks at OHSU; defendant convicted on multiple charges (attempted murder acquitted).
State sought $46,403.04 restitution representing amounts CareOregon (Medicaid CCO) paid of $262,006.83 billed; evidence included claim forms and a CareOregon subrogation ledger and witness testimony about payment rates.
CareOregon witness testified payments were made at Medicaid/contract rates ("much lower" than commercial) but did not review individual services for reasonableness.
Trial court denied restitution, concluding the state failed to prove the medical charges were "reasonable" under ORS 137.103(2) and ORS 31.710, relying on State v. McClelland.
State cross-appealed; appellate majority reversed on cross-appeal, holding insurer payments at or below market (Medicaid) rates can supply sufficient evidence of reasonableness for restitution and remanded.
Defendant's direct appeal (jury instructions/merger) was affirmed without written discussion.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether restitution for medical expenses requires additional proof beyond insurer payment to show "reasonable charges" under ORS 31.710/137.103	Payments by a health insurer (CareOregon) at contracted/Medicaid rates are prima facie evidence of market-rate reasonableness; that evidence was sufficient here	Medical bills or insurer payment alone cannot establish reasonableness; need testimony (physician or billing expert) tying charges to necessity and customary rates (McClelland)	Reversed trial court: insurer payments at or below market (here Medicaid/contract) provide sufficient evidence to permit a factfinder to find charges "reasonable" for restitution purposes; remanded for entry of restitution to CareOregon
Whether the state needed to separately prove necessity of each treatment at the restitution hearing	Necessity may be proven by trial evidence; restitution need only show reasonable value (market rate) and necessity was not contested here	State must connect each expense to necessary treatment and rule out less costly alternatives	Held that reasonableness and necessity are distinct; necessity evidence existed in the trial record and need not be re-proved at restitution when trial presented it; the restitution denial based solely on lack of reasonableness evidence was error

State v. McClelland, 278 Or. App. 138 (Or. Ct. App. 2016) (medical bill alone insufficient to prove reasonableness for restitution)
White v. Jubitz Corp., 347 Or. 212 (Or. 2009) (amount paid is admissible and often important in establishing reasonable value of medical services)
Ellington v. Garrow, 213 Or. App. 490 (Or. Ct. App. 2007) (physician testimony sufficient to permit inference that charges were reasonable)
Valdin v. Holteen and Nordstrom, 199 Or. 134 (Or. 1953) (payment evidence must be connected to proof that charges and services were reasonable and performed)
State v. Jordan, 249 Or. App. 93 (Or. Ct. App. 2012) (insurer lien ledger is more than a bill and may bear on reasonableness)
State v. Ramos, 358 Or. 581 (Or. 2016) (restitution informed by civil-law concepts of economic damages)
Lea v. Farmers Ins. Co., 194 Or. App. 557 (Or. Ct. App. 2004) (bill without further proof insufficient to establish reasonableness)
Coblentz v. Jaloff, 115 Or. 656 (Or. 1925) (allegation of medical charges without proof of payment or reasonableness insufficient)