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A BILL TO BE ENTITLED
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AN ACT
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relating to recovery of medical or health care expenses in civil |
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actions. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 41.0105, Civil Practice and Remedies |
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Code, is amended to read as follows: |
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Sec. 41.0105. EVIDENCE RELATING TO AMOUNT OF ECONOMIC |
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DAMAGES. (a) In addition to any other limitation under law, |
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recovery of medical or health care expenses in a civil action |
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[incurred] is determined in accordance with this section [limited |
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to the amount actually paid or incurred by or on behalf of the |
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claimant]. |
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(b) In a civil action in which medical or health care |
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expenses are actually paid by the claimant, a health benefit plan, |
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workers' compensation insurance, an employer-provided plan, |
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Medicaid, or Medicare, a party may introduce in evidence only the |
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amounts actually paid to the medical or health care provider for the |
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services provided to the person whose injury or death is the subject |
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of the action. |
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(c) In a civil action other than an action described by |
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Subsection (b), a party may introduce evidence that has a tendency |
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to prove the fair and reasonable value of the necessary medical or |
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health care services provided to the person whose injury or death is |
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the subject of the action. |
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(d) In any civil action, a party may introduce in evidence |
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the amounts paid to a medical or health care provider for services |
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provided to the person whose injury or death is the subject of the |
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action by a cafeteria plan or health savings account or by any |
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person to satisfy a copayment or deductible. |
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(e) In any civil action in which a claimant seeks recovery |
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of medical or health care expenses, the claimant shall disclose to |
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all parties any formal or informal agreement under which the |
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medical or health care provider who provided the services may |
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wholly or partly refund, rebate, or remit any amount of money or |
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give anything of value to the claimant or anyone associated with the |
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claimant. |
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SECTION 2. Section 18.001, Civil Practice and Remedies |
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Code, is amended by amending Subsections (b), (c), (e), (e-1), (h), |
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and (i) and adding Subsection (b-1) to read as follows: |
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(b) Unless notice of intent to controvert the |
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reasonableness of the amounts charged or the necessity for medical |
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services [a controverting affidavit] is served as provided by this |
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section, an affidavit complying with this section and stating that |
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the amount a person charged for a service was reasonable at the time |
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and place that the service was provided and that the service was |
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necessary is sufficient evidence to support a finding of fact by |
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judge or jury that the amount charged was reasonable or that the |
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service was necessary. The affidavit is not evidence of and does |
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not support a finding of the causation element of the cause of |
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action that is the basis for the civil action. |
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(b-1) Notwithstanding Subsection (b), the reasonableness of |
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charges and the necessity of services are matters for decision by |
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the finder of fact, and the affidavit described by Subsection (b) |
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has no effect except to prove the authenticity of the medical |
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records described by the affidavit if notice of intent to |
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controvert the reasonableness of the amounts charged or necessity |
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for medical services is served as provided by this section. |
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(c) The affidavit must: |
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(1) be taken before an officer with authority to |
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administer oaths; |
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(2) be made by: |
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(A) the person who provided the service; or |
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(B) the person in charge of records showing the |
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service provided and charge made; and |
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(3) include an itemized statement of the service and |
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charge using the current version of the form CMS-1450 or UB-04 or |
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CMS-1500 or HFCA-1500, as applicable. |
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(e) A party intending to controvert the reasonableness of |
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the amounts charged or necessity for medical services [a claim |
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reflected by the affidavit] must serve notice of that intent [a copy |
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of the counteraffidavit] on each other party or the party's |
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attorney of record by the earlier of: |
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(1) 120 days after the date the defendant files its |
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answer; |
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(2) the date the party serving notice [offering the |
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counteraffidavit] must designate expert witnesses under a court |
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order; or |
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(3) the date the party serving notice [offering the |
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counteraffidavit] must designate any expert witness as required by |
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the Texas Rules of Civil Procedure. |
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(e-1) Notwithstanding Subsection (e), if the party offering |
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the affidavit [in evidence] serves a copy of the affidavit under |
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Subsection (d-1), notice of intent to controvert the reasonableness |
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of the amounts charged or necessity for medical services must be |
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served [the party offering the counteraffidavit in evidence or the |
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party's attorney must serve a copy of the counteraffidavit] on each |
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other party to the case by the later of: |
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(1) 30 days after service of the affidavit on the party |
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serving notice [offering the counteraffidavit in evidence]; |
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(2) the date the party serving notice [offering the |
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counteraffidavit] must designate any expert witness under a court |
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order; or |
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(3) the date the party serving notice [offering the |
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counteraffidavit in evidence] must designate any expert witness as |
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required by the Texas Rules of Civil Procedure. |
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(h) If continuing services are provided after a relevant |
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deadline under this section: |
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(1) a party may supplement an affidavit served by the |
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party under Subsection (d) or (d-1) on or before the 60th day before |
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the date the trial commences; and |
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(2) a party that served notice [a counteraffidavit] |
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under Subsection (e) or (e-1) may serve notice related to the |
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supplemental affidavit [supplement the counteraffidavit] on or |
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before the 30th day before the date the trial commences. |
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(i) Notwithstanding Subsections (d), (d-1), (d-2), (e), |
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(e-1), [(g),] and (h), a deadline under this section may be altered |
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by all parties to an action by agreement or with leave of the court. |
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SECTION 3. Sections 18.001(f) and (g), Civil Practice and |
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Remedies Code, are repealed. |
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SECTION 4. Sections 18.001 and 41.0105, Civil Practice and |
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Remedies Code, as amended by this Act, apply only to an action |
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commenced on or after the effective date of this Act. An action |
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commenced before the effective date of this Act is governed by the |
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law applicable to the action immediately before the effective date |
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of this Act, and that law is continued in effect for that purpose. |
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SECTION 5. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2021. |
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