By a 7-4 margin, the House Judiciary & Civil Jurisprudence Committee has advanced SB 30, which now deals solely with evidence of medical damages. During the discussion in committee this morning, Chairman Leach laid out a committee substitute. Once it was adopted, Rep. Moody outlined the provisions of a floor amendment that the bill’s sponsor, Rep. Bonnen, has agreed to accept. What is given below is an effort to the marry the committee substitute with the proposed floor amendment, so you can get an idea of what will change when the bill is debated in the next few days.
SB 30 by Schwertner (R-Georgetown): Makes numerous changes to medical and noneconomic damages. The House committee substitute shows in red. Changes (both added and stricken language) that will be made on the floor in an agreed floor amendment appear in blue.
- Amends § 41.001, CPRC, to add definitions of “health care expenses,” “health care services,” “injured individual,” “letter of protection,” “physician,” “provider,” and “third-party payor”:
- Adds § 41.015, CPRC, to provide that if a third-party payor paid for a health care service, supply, or device, the evidence offered to prove the amount of medical damages is limited to evidence of the amount paid, plus amounts paid by an insured for coinsurance, deductibles, or copayments;
- Provides that if a third-party payor did not pay for the service, supply, or device, a party may offer and the court shall admit the following evidence may be offered regarding the reasonable value of necessary health care services [or that in a reasonable probability will need to be provided in the future includes]: (1) evidence of amounts paid by non-third-party payors to providers (but not to purchase an account receivable or as a loan) if paid without [a formal or informal] agreement for the provider to refund, rebate, or remit money to the payor, injured individual, claimant, or claimant’s attorney or anyone associated therewith; and (2) Medicare allowable amounts, maximum allowable workers’ comp rates, the 50th percentile of amounts allowed to participating providers in the geozip during the calendar quarter in which the service was provided;
- Provides that if a claimant gives a notice of intent within the § 18.001(d) affidavit deadline [that the claimant intends to rely on], the following shall be admitted: (1) the average amounts collected by the provider for the service during the preceding year, (2) the provider’s range of contracted rates with commercial insurers, and the provider’s billed charges, and (3) the provider’s billed charges;
- Prohibits a party from compelling a provider by pretrial discovery request or subpoena to provide any of that information unless the claimant services notice of intent as provided above;
- Provides that, except as provided by SCOTX rules, for each service, supply, or device a provider’s statements or invoices submitted into evidence must include Current Procedural Terminology, Healthcare Common Procedure Coding System, or Evaluation and Management code if the service, etc. has such a code [an industry-accepted billing code], a description of the service, and the date on which the service was provided;
- Allows a party to offer and requires the court to admit evidence of Medicare, Workers’ Comp, or commercial provider rates through expert witnesses or cross-examination of another party’s witness if the offering party gives at least 45 days’ notice before trial;
- Adds § 41.016, CPRC, to require a claimant to disclose (1) any letter of protection related to the action; (2) any [oral or written] agreement under which a provider may kick back any money to a payor, injured individual, claimant, claimant’s attorney or anyone associated therewith; and (3) the identity of any provider who provided services to the injured individual, together with an authorization to all other parties allowing them to obtain all of the injured individual’s medical records relating to the claim; [and (4) if the individual was referred to the provider and the provider’s medical records, billing statements, or testimony will be presented at trial, the contact information of the peron who made the referral, the relationship of the referrer and the injured individual’s attorney, and the relationship of the referrer and the injured individual or his or her attorney];
- Requires a claimant, on request of a party, to state the name, address, and telephone number of each person who provided to the claimant or injured individual the contact information of a provider that provided a service to injured individual, even if the person is or was an attorney for the claimant or injured person;
- Requires a provider, on request of a party, to provide (1) the number of persons an attorney to the action referred to the provider in the preceding two years [an anonymized list of persons referred by an attorney to the action], (2) the total amount paid to the provider in the preceding two years by or on behalf of persons referred by an attorney to the action [the date and amount of each payment to the provider by, through, or at the direction of the attorney (preceding two years), (3) any person anonymously described above on whose behalf the attorney made a payment, and (4) any other aspects of any financial relationship between the referring attorney and the provider];
- [Includes in the term “referral” a referral by made by another person if the injured individual’s attorney knew or had reason to know about the referral];
- Mandates admission into evidence (1) medical records showing health care services, etc. provided to the injured individual to diagnose, alleviate, cure, treat, or heal the injury [the injured individual’s medical records relating to the event that caused the injury], (2) a letter of protection if a provider’s medical records, billing statements, or testimony will be presented, and (3) referral information if a provider’s medical records, billing statements, or testimony will be presented [and (4) treatment guidelines and drug formularies approved by the Workers’ Comp Division as evidence relating to the necessity of the services];
- Provides that the TRE apply except as otherwise provided by §§ 41.015 and 41.016;
- Applies to an action (1) commenced on or after the effective date [or (2) pending on the effective date and in which a trial, or a new trial or retrial following a motion, appeal, or otherwise begins on or after January 1, 2026].
