SHAPIRO, P.J.

Defendant, K. Thomas Crocker, D.O.,1 performed orthopedic surgery on plaintiff's ankle on September 28, 2008, and for some time thereafter provided plaintiff postsurgical care. Plaintiff later filed the instant medical malpractice action, alleging that he suffered injury resulting from violations of the standard of care by defendant during surgery and during postsurgical care. Shortly before the scheduled trial date, the trial court ruled on several motions in limine. We granted plaintiff's interlocutory application for leave to appeal one of these pretrial rulings.2 Defendant then cross-appealed the trial court's rulings on two other motions in limine.

Plaintiff appeals the trial court's ruling that one of plaintiff's proffered expert witnesses may not testify regarding the standard of care applicable to the treatment provided by defendant to plaintiff. Defendant cross-appeals two other rulings: the trial court's grant of plaintiff's motion to preclude any reference to plaintiff's receipt of no-fault motor vehicle insurance benefits and the trial court's denial of defendant's motion to "strike allegations of malpractice." In plaintiff's appeal, we reverse on the basis of the text of the controlling statute. In defendant's cross-appeal, we affirm the trial court's ruling regarding plaintiff's receipt of no-fault benefits, but reverse, in part, the trial court's denial of defendant's request to strike allegations.

I. PLAINTIFF'S APPEAL

In a medical malpractice case, a plaintiff must establish that the medical care provided by the defendant fell below the standard of medical care applicable at the time the care was provided. This is set forth in MCL 600.2912a(1): "[I]n an action alleging [medical] malpractice, the plaintiff has the burden of proving that in light of the state of the art existing at the time of the alleged malpractice ...." (Emphasis added.)

By way of example, if a doctor is sued for malpractice alleged to have occurred on September 1, 2010, the question of whether the doctor was professionally negligent turns on whether he or she complied with the standard of care as it existed on September 1, 2010. Medicine is a constantly evolving science, but a physician's conduct and decision-making must be judged against the standard of care that applied when the physician acted, not against some standard that developed thereafter. Put simply, changes in the standard of care do not apply retroactively in medical malpractice suits.

Consistent with this principle, a physician who testifies regarding the standard of care at issue must have possessed, on the date of the alleged malpractice, the same relevant specialty qualifications as the defendant. This is set forth in MCL 600.2169(1)(a), which provides:

The trial court concluded that one of plaintiff's expert witnesses, Dr. David Viviano,3 cannot satisfy MCL 600.2169(1)(a) and so may not testify regarding the standard of care. This was error. Because Viviano and defendant were both board-certified orthopedic specialists at the time of the alleged malpractice (i.e., "at the time of the occurrence that is the basis for the action"), Viviano meets the requirements of the statute and so may testify with regard to standard of care issues.

At the time of the alleged malpractice, defendant was a board-certified specialist in orthopedic surgery. And, at the time of the alleged malpractice, Viviano was also a board-certified specialist in orthopedic surgery. Both defendant and Viviano have continued to practice as orthopedic specialists. However, after the time of the alleged malpractice, Viviano's board certification lapsed and he has not renewed it.4 Defendant argued, and the trial court agreed, that under MCL 600.2169(1)(a), Viviano could not offer expert standard-of-care testimony at trial because, although he was a board-certified specialist at the time of the alleged malpractice, it was likely that he would not be board-certified at the time of trial.

This case involves the interpretation of a statute, which presents a question of law subject to review de novo. Woodard v. Custer, 476 Mich. 545, 557, 719 N.W.2d 842 (2006). As our Supreme Court has instructed,

The statute refers to two different individuals: the defendant and the expert.5 It also refers to two different, but interrelated, qualifications: medical specialty6 and board certification.7 If the defendant is a specialist, the testifying expert must have been a specialist in the same specialty at the time of the occurrence that is the basis for the action. If the defendant is board-certified in a specialty, then the testifying expert must have been board-certified in the same specialty. We are tasked with determining when the testifying expert must have been board-certified. Contrary to defendant's argument, which was adopted by the trial court, we conclude that an expert testifying against a board-certified defendant must have been board-certified in the same specialty as the defendant at the time of the occurrence that is the basis for the action.

Defendant's primary argument is that the second sentence of MCL 600.2169(1)(a) employs the present tense and, therefore, must refer to the time when the testimony is delivered. However, this argument is belied by the first sentence of MCL 600.2169(1)(a), which employs the same present-tense verbs yet plainly refers to a past time period, i.e., the time of the occurrence that is the basis for the action. That is, the first sentence provides: "If the party against whom or on whose behalf the testimony is offered is a specialist, specializes at the time of the occurrence that is the basis for the action in the same specialty as the party against whom or on whose behalf the testimony is offered." (Emphasis added.) Thus, despite employing the word "is," i.e., the present-tense form of the verb "to be," the first sentence still requires that the time at which the expert witness must so specialize be a time in the past in relation to the trial, i.e., at the time of the occurrence that is the basis for the action. The second sentence employs nearly identical present-tense verbs: "if the party against whom or on whose behalf the testimony is offered is a specialist who is board certified, the expert witness must be a specialist who is board certified in the specialty." (Emphasis added.) Accordingly, defendant's argument that the present-tense verbs employed by the second sentence of the statute require that they be read to apply to the "present," i.e., the time of the testimony, is belied by the sentence directly before it and ignores our mandate to read the statute as a whole. Bush, 484 Mich. at 166-167, 772 N.W.2d 272.

Defendant's present-tense argument is also defeated by reading the statute in its grammatical context. Removing the clauses related to the defendant, and considering only those relevant to the testifying expert, the statute reads:

This reading more clearly demonstrates that the plain language of the second sentence of MCL 600.2169(1)(a) is an extension of the first. If the defendant is a board-certified specialist, the statute requires that a testifying expert must "specialize[] at the time of the occurrence that is the basis for the action in the same specialty ... [and be] board certified in that specialty." This statute, indeed the relevant subsection itself, provides that the time when an expert must be similarly qualified as the defendant is the time of the occurrence that is the basis for the action. There is no indication, explicit or implied, that the Legislature intended that a wholly different time, i.e., the time when the testimony is delivered, is to apply when a defendant is a board-certified specialist, as opposed to merely a specialist.

As our Supreme Court has stated, the second sentence of MCL 600.2169(1)(a) provides an "additional" requirement. Halloran v. Bhan, 470 Mich. 572, 578, 683 N.W.2d 129 (2004) (emphasis omitted). That requirement provides that an expert testifying against a board-certified defendant must also be board-certified in that same specialty. By imposing an "additional" requirement, the second sentence adds to, rather than contradicts, the first. Defendant offers no basis to conclude that the Legislature intended that a "specialist" must specialize at the time of the occurrence that is the basis for the action, but that a "board-certified specialist" must be board-certified at a completely different time, i.e., the time when his or her testimony is delivered. In the absence of any reference to a specific and different time period by the Legislature, we must conclude that the time period for board-certified specialists under MCL 600.2169(1)(a) is the time of the occurrence that is the basis for the action. See King v. Reed, 278 Mich.App. 504, 515, 751 N.W.2d 525 (2008) ("This Court will not read anything into a statute that is not within the manifest intent of the Legislature, as gleaned from the language of the statute itself.").

Our interpretation is also consistent with the Legislature's most recent amendment of the statute. "[C]ourts must pay particular attention to statutory amendments, because a change in statutory language is presumed to reflect either a legislative change in the meaning of the statute itself or a desire to clarify the correct interpretation of the original statute." Bush, 484 Mich. at 167, 772 N.W.2d 272. Before it was amended in 1993, 1993 PA 78, to its current version, the statute provided:

With the removal of these two emphasized phrases, the Legislature made clear that it intended to remove an "either/or" determination from the statute. That is, under the previous version of the statute, an expert witness was qualified to testify against a specialist defendant if the expert specialized at the time of trial and/or at the time of the occurrence. Under the amended statute, the relevant qualifications must be met only at the time of the occurrence that is the basis for the action.

Like the plain language of the statute, caselaw also requires that if the defendant was a board-certified specialist at the time of the occurrence that is the basis for the action, any expert testifying regarding the applicable standard of care must also have been a board-certified specialist at the time of the occurrence that is the basis for the action. In Woodard, 476 Mich. at 560, 719 N.W.2d 842, our Supreme Court explained the statute as follows:

The Supreme Court, consistent with the language of the statute, did not specify that an expert testifying against a board-certified defendant must have been board-certified at any other time than the time of the occurrence that is the basis for the action. Woodard also provides that

It is undisputed that Viviano obtained (past tense) the relevant board certification; that he no longer possesses the certification does not alter the fact that it had been obtained and was in effect at the time of the occurrence that is the basis for the action. Moreover, Woodard specified that if a defendant physician has received (again, using the past tense) board certification, the testifying expert must have obtained the same certification. Accordingly, Woodard is consistent with our interpretation of MCL 600.2169(1)(a).

We reject defendant's argument that a different result is dictated by a passage from Halloran, 470 Mich. at 578-579, 683 N.W.2d 129, wherein the Supreme Court interpreted MCL 600.2169(1)(a) as follows:

Defendant cites this passage for the proposition that the second sentence of MCL 600.2169(1)(a) imposes a separate and independent evidentiary requirement that must be read separately from the rest of the statute. This argument is not only contrary to the canons of statutory interpretation, Bush, 484 Mich. at 166-167, 772 N.W.2d 272, but also mischaracterizes the Supreme Court's statement. As a preliminary matter, the instant case concerns different operative facts than did Halloran; that is, we do not consider the two sentences of MCL 600.2169(1)(a) as applied to this case, other than to interpret the second sentence with reference to the first. Substantively, we do not reject Halloran's mandate that the second sentence imposes a requirement that must be applied to board-certified standard-of-care expert witnesses in medical malpractice cases. Halloran mandates that "the witness must... share the same board certification as the party against whom or on whose behalf the testimony is offered." Halloran, 470 Mich. at 579, 683 N.W.2d 129. We merely address at what time the witness must share that board certification, a question not addressed in Halloran, therefore rendering that opinion inapplicable in this case.

Defendant's suggested interpretation would also have additional confounding consequences when the defendant physician was board-certified at the time of the occurrence but had retired, died, or allowed his or her certification to lapse before trial. In such cases, testing board certification at the time of trial, rather than the occurrence, would permit testimony from an expert who had never been board-certified. Even if a defendant retained his or her board certification throughout the litigation, defendant's interpretation would allow for standard of care testimony by a specialist who was not board-certified at the time of the occurrence but became board-certified during the pendency of the litigation.

In accordance with the plain language of the statute, its most recent amendment, the relevant caselaw, and common sense, we hold that, under MCL 600.2169(1)(a), an expert witness seeking to offer standard-of-care testimony against or on behalf of a board-certified specialist must himself or herself have been board-certified in the same specialty at the time of the occurrence that is the basis for the action. Thus, in this case, the trial court erred by granting defendant's motion in limine to exclude Viviano's standard-of-care testimony.

II. DEFENDANT'S CROSS-APPEAL

A. MOTION TO STRIKE ALLEGATIONS

Plaintiff's complaint alleges that defendant committed medical malpractice in treating a trimalleolar facture of plaintiff's right ankle. The complaint alleges 10 specific instances of professional negligence on the part of defendant. The two specific alleged breaches of the applicable standard of care relevant to defendant's cross-appeal are plaintiff's claims that: (1) defendant improperly employed screws and a plate in the surgery he performed on plaintiff's ankle and (2) defendant improperly told plaintiff that he could bear weight on his ankle. One of plaintiff's expert witnesses, Dr. Antoni Goral, was deposed regarding defendant's treatment of plaintiff. Goral testified that defendant's placement of the plate, and the number of screws employed, violated the applicable standard of care. However, Goral did not dispute defendant's counsel's assertion that, based on the evidence available, this specific alleged breach of the standard of care did not cause damage to plaintiff. Goral also testified that defendant's postsurgery advice to plaintiff that he could bear weight on his ankle violated the applicable standard of care. However, he similarly testified that this alleged improper advice, on the evidence available, did not cause damage to plaintiff.

Defendant filed a motion in limine to "strike allegations of malpractice" and to preclude plaintiff from offering any evidence regarding these two alleged breaches of the standard of care at trial. Defendant argued that, considering Goral's testimony, plaintiff could not establish a causal link between these two alleged breaches and plaintiff's claimed injuries and damages and that, therefore, any reference to the acts must be excluded. In response, plaintiff acknowledged that Goral's statements, on their own, were insufficient to establish that the two alleged breaches caused plaintiff injury. However, plaintiff asserted that evidence of the two alleged breaches was nonetheless relevant to his argument that, "notwithstanding [defendant's] claim that he has performed a hundred of [sic] ankle fracture repairs, [he] does not have the requisite skill or ability to properly fixate a trimalleolar fracture" and that the evidence "still goes to his overall knowledge and skill in the repair of these type of fractures."

The trial court denied defendants' motion, holding as follows:

Defendant's artfully titled "motion to strike allegations" actually presents two distinct issues. First, in what is effectively a request for partial summary disposition, defendant argues that because there is no evidence that these two particular breaches caused injury, plaintiff may not seek damages for those violations. Whether a plaintiff's claim of medical malpractice fails in whole or in part as a matter of law is an issue of law that we review de novo. King, 278 Mich.App. at 520, 751 N.W.2d 525. After conducting review de novo, we agree with defendant that plaintiff may not seek damages for those violations and that the trial court, insofar as it did not so rule, was in error. See Wischmeyer v. Schanz, 449 Mich. 469, 484, 536 N.W.2d 760 (1995).

The second issue raised in defendant's motion is the request that the trial court exclude all evidence that defendant violated the standard of care in these two respects. This aspect of the motion goes to the admission of evidence, which we review for an abuse of discretion. Albro v. Drayer, 303 Mich.App. 758, 760, 846 N.W.2d 70 (2014). We agree with the trial court that evidence of the course of defendant's violations of the standard of care, even if the violations did not directly cause plaintiff's eventual injury, may be relevant to the jury's understanding of the case.8 But, because we have ruled that plaintiff may not seek damages for those alleged violations, the trial court's view of the calculus of probative value and prejudicial effect may change. See MRE 403. Accordingly, we reverse the evidentiary ruling so that the trial court may exercise its discretion in that context and consider what limiting jury instruction to give in the event it finds the evidence admissible.

B. EXCLUSION OF EVIDENCE OF NO-FAULT BENEFITS

Defendant also argues that the trial court abused its discretion by granting plaintiff's motion to exclude evidence of any no-fault insurance benefits plaintiff received. We disagree.

In the present case, plaintiff fractured his ankle while changing a tire on a motor vehicle; therefore, he received no-fault insurance benefits from his motor vehicle insurance carrier after the accident. Plaintiff moved to exclude from trial any evidence of his no-fault benefits, including the reimbursement of his medical expenses and payment of wage loss benefits. He argued that under MCL 600.6303, the amount of any medical malpractice judgment would be reduced by the amount of these no-fault payments after trial9 and so introduction of evidence of those payments during trial could result in a double-reduction or other prejudice.

In response, defendant argued that he wished to introduce evidence regarding the existence and amount of no-fault benefits paid to plaintiff as support for defendant's claim that plaintiff was malingering and not actually seriously injured. Evidence of insurance coverage may not be introduced for the purpose of mitigating damages. Nasser v. Auto Club Ins. Ass'n., 435 Mich. 33, 58, 457 N.W.2d 637 (1990). However, this rule is not an absolute bar to the admission of such evidence. An exception to the general rule of exclusion exists "where the evidence is sought to prove malingering or motivation on the plaintiff's part not to resume employment or to extend the disability." Id.

Certainly, defendant may assert at trial that plaintiff is a malingerer. And, defendant has significant evidence upon which to base this argument. Another physician who treated plaintiff opined that plaintiff was "a non-compliant, unmotivated patient who has exaggerated his injuries and/or pain" and that plaintiff's "current status is best explained by his lack of motivation to improve his medical condition, secondary gain, and lack of compliance with his healthcare providers." Defendant also points to evidence that doctors other than defendant had cleared plaintiff to return to work and plaintiff's deposition testimony, in which he stated that shortly before his injury he learned that he was going to be fired from his job and that he remained capable of attending school.

The trial court granted plaintiff's motion, holding as follows:

When there is evidence other than insurance coverage to suggest malingering, admission of evidence of insurance coverage is left to the discretion of the trial court. Nasser, 435 Mich. at 59-60, 457 N.W.2d 637. In exercising this discretion, the trial court must undertake an analysis under MRE 403. Id. The court must weigh the probative value of the evidence against "the danger of unfair prejudice, confusion of the issues, or misleading the jury, or by considerations of undue delay, waste of time, or needless presentation of cumulative evidence. [MRE 403.]

The trial court recognized the applicability of MRE 403 and made findings consistent with the language of the rule. There was no abuse of discretion. First, the evidence of plaintiff's no-fault insurance benefits is cumulative in light of the other evidence available to defendant to support his claim of malingering. Second, since plaintiff's no-fault wage loss benefits must, by statute, have terminated in 2011, their probative value is limited. See MCL 500.3107(1)(b). Moreover, presentation of evidence of plaintiff's no-fault benefits has the potential to mislead and confuse the jury so that it might conclude that it should reduce plaintiff's damages by the amount of his insurance benefits, which is a matter solely left to the trial court after the verdict. See MCL 600.6303. Perhaps more important in terms of judicial efficiency, allowing introduction of this marginally probative evidence would result in a minitrial on the question of whether plaintiff was legally and factually entitled to no-fault benefits. If evidence of the receipt of the benefits is admitted to show that plaintiff was wrongly seeking financial gain, plaintiff would be entitled to respond with proofs that his receipt of these benefits was proper. This process could include the calling of more physician witnesses, insurance company adjustors and other personnel, and the review of internal insurance company documents, among additional otherwise extraneous proofs.

In sum, the trial court did not abuse its discretion when it determined that, although there was evidence to support defendant's theory of malingering, evidence of collateral source payments, in the form of plaintiff's no-fault benefits, was not admissible because the probative value of this evidence was substantially outweighed by the danger of unfair prejudice. MRE 403.

We reverse the trial court's ruling that Dr. Viviano may not testify regarding the applicable standard of care. We reverse the trial court's denial of defendant's motion to strike allegations insofar as it denied defendant's request to bar an award of damages for the two alleged violations of the standard of care on which plaintiff has not offered evidence of causation, and instruct the trial court on remand to reconsider defendant's request to exclude evidence of those two alleged violations of the standard of care. We affirm the trial court's grant of plaintiff's motion to exclude evidence of no-fault insurance benefits. This case is remanded to the circuit court for proceedings consistent with this opinion. We do not retain jurisdiction.

WHITBECK and STEPHENS, JJ., concurred with SHAPIRO, P.J.