SB 30 revises the standards for the admissibility of evidence concerning health care expenses in personal injury and wrongful death lawsuits. The bill amends Chapter 41 of the Texas Civil Practice and Remedies Code to establish clearer, more precise definitions for terms such as “health care expenses,” “health care services,” “letter of protection,” and “third-party payor.” These definitions create a standardized framework for evaluating what types of damages can be considered and recovered in civil actions involving medical costs.
A central provision of the bill limits the evidence that plaintiffs may present when claiming economic damages for medical care. If a third-party payor (such as private insurance, Medicaid, or Medicare) has paid for the medical services, the evidence is restricted to the actual amounts paid by that third party, plus any out-of-pocket costs like deductibles, copays, or coinsurance. If no third-party payor is involved, the bill allows evidence of amounts paid by others (e.g., direct payment from a private source) only under strict conditions, such as the absence of arrangements to rebate or refund those amounts.
Additionally, SB 30 addresses the admissibility of charges arising under a “letter of protection”—a common litigation tool allowing providers to defer payment in exchange for a share of the settlement or judgment. The bill establishes that such letters are not automatically admissible as proof of the reasonable value of care, further aiming to discourage inflated or speculative billing in civil cases.
The legislation is part of broader tort reform efforts to ensure that recoveries in civil suits reflect actual economic loss rather than theoretical or artificially inflated figures. It seeks to make Texas’s civil justice system more equitable and predictable by tying recoverable medical damages to real-world payments rather than billed amounts, which are often uncollected or deeply discounted in practice.
The Senate Engrossed version and the House Committee Substitute of SB 30 differ significantly in scope, structure, and legal impact. While both versions aim to reform how medical costs are introduced and evaluated in civil litigation, the House version takes a more measured and focused approach, responding to stakeholder concerns and removing broader, more controversial provisions that had been included in the Senate’s version.
The Senate version proposed an expansive overhaul of civil litigation involving not only health care expenses but also non-economic and exemplary damages. It introduced new Subchapters C and D to Chapter 41 of the Texas Civil Practice and Remedies Code, redefining how damages such as pain and suffering are assessed, and adding restrictions on exemplary (punitive) damages. The House Committee Substitute scaled this back considerably, narrowing the bill’s scope to revisions of Section 18.001 and the addition of Section 18.0011, thereby omitting all proposed changes to Chapter 41. This narrowed scope reflects an intent to pass consensus reforms specifically related to health care billing without disrupting broader tort doctrines.
Both versions eliminate the counter-affidavit requirement and replace it with a “notice of intent to controvert.” However, the Senate version more forcefully eliminates the evidentiary value of affidavits once such notice is served and strictly limits the ability of providers to testify if they’ve submitted affidavits, unless exceptions are met. The House version preserves more procedural flexibility, including some of the original counter-affidavit framework. It allows affidavits to retain limited evidentiary value (e.g., proving authenticity of records), and it gives courts discretion over whether provider testimony is allowed. This change softens the Senate’s stricter rules, helping to maintain fairness in litigation.
In the Senate version, the bill imposed rigid monetary caps on the value of health care services—300% of the Medicare fee schedule, adjusted by inflation—as the maximum admissible amount in the absence of third-party payment. This created a hard ceiling for what could be recovered. The House version, however, adopts a more flexible “menu” of admissible evidence to establish reasonable value, including Medicare rates, workers’ compensation fee guidelines, market percentile data, and provider billing records. This multi-pronged approach allows courts and juries to consider case-specific data rather than being bound by a single metric, ensuring that valid claims aren’t barred by an overly rigid formula.
The Senate version proposed sweeping changes to how non-economic damages, such as pain and suffering, emotional anguish, and injury to reputation, are defined, limited, and presented to juries. It sought to establish legal definitions, ban certain types of jury arguments, and require standardized instructions to limit subjective or excessive awards. In contrast, the House version strips these reforms entirely, leaving current law and judicial discretion on noneconomic damages intact. This was likely in response to criticism that such limits could undermine a jury’s ability to compensate victims for real but intangible harm.
The Senate version imposed aggressive disclosure mandates on plaintiffs, particularly requiring detailed financial and referral information about healthcare providers, including past relationships with the plaintiff’s attorney. These were to be automatic and comprehensive. The House version modifies this by shifting many of the disclosure obligations to the healthcare provider (not the plaintiff) and only upon a formal request by another party. This not only reduces the burden and protects attorney-client privilege but also narrows the potential for fishing expeditions and protects plaintiffs’ access to healthcare providers who use letters of protection.
Under the Senate version, once a provider filed a compliant affidavit and chose not to testify, they could not be compelled to respond to discovery or appear at trial. The House version removed this blanket restriction, instead relying on existing discovery procedures and judicial discretion to determine when and how providers may be compelled to provide evidence or testimony. Additionally, while the Senate version introduced a ban on any recovery for services lacking a recognized billing code, the House version omits this, again preserving judicial flexibility and avoiding unintended barriers to legitimate claims.
The Senate version proposed broader applicability, including potential retroactive impact on pending litigation. The House Committee Substitute adopts a more cautious and fair approach by specifying that its provisions apply only to new cases filed after the effective date, or to pending cases in which a new trial begins on or after January 1, 2026. This ensures that litigants already mid-process are not disadvantaged by sudden changes in procedural or evidentiary rules.
In summary, the Senate Engrossed version of SB 30 pursued aggressive tort reform across multiple areas of civil litigation, including damages caps and trial procedures. The House Committee Substitute scales back these reforms to focus primarily on healthcare billing affidavit practices under Section 18.001. The substitute retains the bill’s goal of improving the integrity and efficiency of medical damage claims while balancing access to justice, preserving judicial discretion, and responding to concerns about overreach.
Contact the Author
Sen. Charles Schwertner
