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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 incurred is limited to |
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the amount actually paid or incurred by or on behalf of the |
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claimant. |
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(b) Subject to Subsection (a), a party in an action in which |
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a claimant seeks recovery of medical or health care expenses may |
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introduce evidence of the reasonableness of the amount charged for |
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medical or health care services provided to the claimant, |
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including: |
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(1) the amount actually paid for the medical or health |
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care services provided to the claimant, unless there is a formal or |
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informal agreement that the medical or health care provider will |
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wholly or partly refund, rebate, or remit the amount paid to the |
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payer or another person, in which case the amount actually paid is |
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not admissible in evidence; |
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(2) the amount billed by the medical or health care |
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provider for the medical or health care services provided to the |
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claimant; |
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(3) the amount paid, the amount that would have been |
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paid, or the amount likely to be paid for the medical or health care |
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services provided to the claimant by a health benefit plan, |
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workers' compensation insurance, an employer-provided plan, |
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Medicaid, Medicare, or another similar source available to pay for |
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services provided to the claimant at the time the services were |
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provided or available to pay for the services after the services |
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were provided, as applicable; |
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(4) the average amount typically paid or allowed by |
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health benefit plan issuers or governmental payers at or near the |
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time the medical or health care services were provided to the |
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claimant to medical or health care providers who: |
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(A) are located in the same geographic area as |
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the medical or health care provider who provided the services to the |
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claimant; and |
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(B) offer the same type of medical or health care |
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services as the services provided to the claimant; or |
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(5) the average of the amounts actually accepted for |
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payment in the previous 12 months by the medical or health care |
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provider who provided medical or health care services to the |
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claimant for the same services provided to patients other than the |
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claimant. |
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SECTION 2. Section 41.0105, Civil Practice and Remedies |
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Code, as amended by this Act, applies only to an action commenced on |
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or after the effective date of this Act. An action commenced before |
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the effective date of this Act is governed by the law applicable to |
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the action immediately before the effective date of this Act, and |
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that law is continued in effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2021. |