
On March 13, 2025, the Texas House of Representatives introduced House Bill 4806,[1] authored by Representative Greg Bonnen, to limit the recovery of damages in civil actions. Lieutenant Governor Dan Patrick announced that this Bill is part of his second round of top 40 priority bills for the 89th regular legislative session.[2] The most notable developments in this Bill are as follows:
1. It modifies the procedure for challenging the necessity and reasonableness of a plaintiff’s medical services and expenses. Plaintiffs rely on Section 18.001 affidavits to establish the necessity and reasonableness of their medical expenses and services. In response, defendants currently contest these affidavits through a Section 18.001 controverting affidavit. House Bill 4806 proposes requiring a defendant to instead issue a notice of intent to controvert the reasonableness of the charged amounts and the necessity of services.
Furthermore, this Bill would impose a more substantial impact on such opposition. Specifically, this notice would render a plaintiff’s Section 18.001 affidavit completely ineffective, except for authentication purposes. Lastly, this Bill would prohibit a defendant from challenging the reasonableness of medical expenses in Section 18.001 affidavits when such expenses are supported by the same equation used to calculate the “past medical expenses cap” discussed in subpart 3 herein.[3]
2. It defines certain noneconomic damages. Aligning with Texas case law, this Bill clarifies that future damages are not merely “damages that are incurred after the date of the judgment” but rather “damages that, in reasonable probability, can be expected to be incurred after the date of the judgment.” This Bill’s definition of “future loss of earnings” similarly incorporates this statutory expectation of reasonable probability.
Additionally, under House Bill 4806, “future loss of earnings” would no longer include loss of income, wages, or earning capacity. This Bill’s proposed revisions regarding the definition of key damage terms do not end there. House Bill 4806 statutorily defines what constitutes “mental or emotional pain or anguish”[4] and “physical pain and suffering.”[5]
3. It adds two new subchapters to Chapter 41, Section 8 that limit a plaintiff’s recovery for medical expenses, and mandate often-disputed disclosures. This new subchapter would provide for a “past medical expenses cap,” namely: a plaintiff’s recovery of damages for past healthcare services would be limited to the sum of all amounts paid by third-party payors,[6] the plaintiff, and any other non-third-party payors. If no medical expenses have been paid or the foregoing is otherwise not applicable, then an award of past medical expenses would be capped at “150 percent of the median amount paid by nongovernmental third-party payors to health care providers for the same types of services provided to the injured individual during the month in which the services were provided as drawn from the database for the geozip: (A) in which the services were provided, if the services were provided in this state; or (B) in which The University of Texas Health Science Center at Houston is located, if the services were provided outside of this state.” Notably, House Bill 4806 would also ensure that should an injured individual fail to use available health benefits, a court is to deem it a failure to mitigate damages. Similarly, this new subchapter includes a “future medical expenses cap” that mirrors the “150 percent of the median amount” catchall applicable for the “past medical expenses cap.” Finally, the Bill proposes a new subchapter, which would require the disclosure of, among other things, plaintiff’s: (1) letters of protection with health care providers; (2) lists of medical providers treating the subject injuries; (3) medical authorizations; (4) lists of potential third-party payors for the disputed health care services; and (5) sources of any referrals for health care services. As to the referral disclosure requirement, should the plaintiff’s attorney be the referring party, the plaintiff must also disclose the below. The admissibility of each is specifically protected by the Bill.
- An anonymized list of persons referred by the attorney to the provider in the preceding two years;
- The date and amount of each payment made to the provider in the preceding two years by or at the direction of the attorney;
- If applicable, each person anonymously described under Subparagraph (a) on whose behalf a payment described by Subparagraph (b) was made; and
- Other aspects of any financial relationship between the attorney and the provider.
4. It introduces several measures to curb excessive noneconomic damage awards. First, House Bill 4806 would require a unanimous jury decision—rather than the current 10-out-of-12 standard—to award damages for physical pain and suffering or for mental or emotional pain or anguish. Second, complementing the Bill’s newly added definitions discussed in subpart 2 herein, the Bill codifies Texas case law and proposes that all awards for physical pain and suffering and mental or emotional pain or anguish: (1) “must be based on evidence of the nature, duration, and severity of the injury and reflect a rational connection, grounded in the evidence, between the injury suffered and the dollar amount necessary to provide fair and reasonable compensation to a claimant;” (2) “may not be used to penalize or punish a defendant, make an example to others, or serve a social good;” and (3) “may not include amounts that are properly considered economic losses, such as lost earnings caused by physical impairment or medical expenses incurred for emotional or psychological care.” Third, House Bill 4806 specifically prohibits anchoring and attempts to establish a valuation of human life. Fourth, under the Bill, a plaintiff’s recovery of noneconomic damages would be limited to past and future physical pain and suffering, mental or emotional pain or anguish, and injury to reputation. Lastly, the Bill grants a personal injury defendant the ability to require that a trial court state the legal and factual basis for a noneconomic damages award—including references to judgments rendered in the state and affirmed on appeal with comparable amounts and facts—if the award exceeds:
- $1 million for past and future mental or emotional pain or anguish in a wrongful death action;
- For past and future damages for physical pain and suffering in a personal injury action, the lesser of:
- three times the amount awarded for past and future health care expenses; or
- $100,000 per year for each year of the claimant’s life expectancy;”
- $1 million for past and future mental or emotional pain or anguish in a personal injury action arising from an event primarily causing emotional injury to a claimant; or
- $250,000 for past and future mental or emotional pain or anguish in a personal injury action arising from an event primarily causing bodily injury to the claimant.
5. It limits the calculation of prejudgment interest. House Bill 4806 calls for prejudgment interest to not only be limited to awards for economic losses, but it also provides that the operative date for calculations shall be the date that the plaintiff’s health care expenses were actually paid, or such other economic losses were actually suffered.
[1] Senate Bill 30, authored by Senator Charles Schwertner, serves as an identical companion bill to House Bill 4806.
[2] https://www.ltgov.texas.gov/2025/03/13/lt-gov-dan-patrick-announces-second-round-of-top-40-priority-bills-for-the-2025-legislative-session/.
[3] House Bill 4806 would require the concession of the reasonableness of medical expenses if: (1) “the affidavit states one of the following amounts as the reasonable charge for the service: (a) the amounts received from all sources by the facility or provider to pay for the service provided to the person whose injury or death is the subject of the action; or (b) an amount that does not exceed 150 percent of the median amount paid by nongovernmental third-party payors to health care facilities or providers for the same type of service provided to the person whose injury or death is the subject of the action during the month in which the service was provided, as drawn from the Texas All Payor Claims Database established under Subchapter I, Chapter 38, Insurance Code, for the geozip: (i) in which the service was provided, if the service was provided in this state; or (ii) Ain which The University of Texas Health Science Center at Houston is located, if the service was provided outside of this state; and (2) the affidavit is accompanied by an invoice for the service that would comply with the clean claim requirements of Chapter 1301, Insurance Code.” Additionally, in the foregoing scenario, if the provider produces a statement that he or she does not intend to appear at trial for purposes of testifying as to the necessity and reasonableness of the health care services and expenses, then discovery and trial testimony of this nature from the provider would be prohibited absent a showing of good cause and lack of unfair surprise.
[4] House Bill 4806 defines “mental or emotional pain or anguish” as follows: “grievous and debilitating angst, distress, torment, or emotional suffering or turmoil that: (a) causes a substantial disruption in a person ’s daily routine; and (b) arises from loss of consortium, loss of companionship and society, loss of enjoyment of life, or a similar mental or emotional injury.”
[5] House Bill 4806 defines “physical pain and suffering” as follows: “painful or distressing sensation associated with an injury or damage to a part of a person ’s body that: A) is consciously felt; (B) is significant in magnitude; and (C)arises from an observable injury or impairment or is shown to exist through objectively verifiable medical evaluation or testing.”
[6] House Bill 4806 explains that “third-party payors” include insurance companies, employer-provided plans, a health maintenance organization, Medicare, Medicaid, and workers’ compensation insurance.