Though House Bill 4806 has not seen substantial movement since its introduction on March 13,[1] its identical counterpart, Senate Bill 30, is steadily progressing through the Texas Senate. Most recently, on April 14, 2025, Senator Schwertner distributed a substituted Senate Bill 30 to the committee on State Affairs, containing 9 substantial changes to Senate Bill 30. Ultimately, the committee did not voice any objections to the substitutions, and the committee adopted the substitutions. That same day, the committee considered Senate Bill 30, as substituted, at a public hearing, a vote was taken, and Senate Bill 30, as substituted, passed through the committee — 9 ayes, 1 nay, and 1 absent. Senate Bill 30, as substituted, is now on the intent calendar awaiting consideration and vote by the Texas Senate.

Senator Schwertner’s 9 primary revisions to the Bill are summarized and copied in pertinent part below.

Change One: The substitute amends language to prohibit from controverting bills already paid or amounts that do not exceed 300% of the Medicare fee scheduled for each service provided.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 18.0011. AFFIDAVIT OF HEALTH CARE FACILITY OR PROVIDER.

(a) A party may not controvert the reasonableness of the charges for health care services stated in an affidavit served under Section 18.001 if, as to each health care service provided by the health care facility or provider:

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 . . . ; 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.		Sec. 18.0011. AFFIDAVIT OF HEALTH CARE FACILITY OR PROVIDER.

(a) A party may not controvert the reasonableness of the charges for health care services stated in an affidavit served under Section 18.001 if, as to each health care service provided by the health care facility or provider to the person whose injury or death is the subject of the action:

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; or

B. If Paragraph (A) does not apply, an amount that, on the date the service was provided, does not exceed 300 percent of the Medicare fee schedule for the service; 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.

Change Two: The substitute further clarifies that the trial court must exclude testimony from the facility or provider in accordance with section 18.0011 unless they indicate a subsequent intention to testify or the party appears at trial.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 18.0011. AFFIDAVIT OF HEALTH CARE FACILITY OR PROVIDER.

(b) If an affidavit of a health care facility or provider served under Section 18.001 complies with Subsection (a) and includes a statement that the facility or provider does not intend to appear at trial to testify regarding the reasonableness of the facility’s or provider’s charges or the necessity for the facility’s or provider’s services, then:

1) A party may not seek to obtain through any pretrial discovery procedure information from the facility or provider about the reasonableness of the facility ’s or provider ’s charges or the necessity for the facility’s or provider’s services; and

2) The trial court shall exclude trial testimony by the facility or provider regarding the reasonableness of the facility ’s or provider ’s charges or the necessity for the facility ’s or provider ’s services unless:

A. The court finds there is good cause to allow the testimony;

B. The testimony will not unfairly surprise or unfairly prejudice any party to the action; and

C. A party opposing admission of the testimony into evidence is given a reasonable opportunity to conduct discovery and present evidence relevant to the testimony to be offered by the facility or provider.		Sec. 18.0011. AFFIDAVIT OF HEALTH CARE FACILITY OR PROVIDER.

(b) If an affidavit of a health care facility or provider served under Section 18.001 complies with Subsection (a) and includes a statement that the facility or provider does not intend to appear at trial to testify regarding the reasonableness of the facility’s or provider’s charges or the necessity for the facility’s or provider’s services, then:

1) A party may not seek to obtain through any pretrial discovery procedure information from the facility or provider about the reasonableness of the facility ’s or provider ’s charges or the necessity for the facility’s or provider’s services; and

2) The trial court shall exclude trial testimony by the facility or provider regarding the reasonableness of the facility’s or provider’s charges or the necessity for the facility’s or provider’s services unless:

A. After the affidavit is served, the facility or provider states an intention to testify at trial or appears at trial to testify;

B. The court finds there is good cause to allow the testimony;

C. The testimony will not unfairly surprise or unfairly prejudice any party to the action; and

D. A party opposing admission of the testimony into evidence is given a reasonable opportunity to conduct discovery and present evidence relevant to the testimony to be offered by the facility or provider.

Change Three: The substitute clarifies that the definitions of “mental or emotional pain or anguish” and “physical pain and suffering” maintain the inclusion of disfigurement, physical impairment, loss of consortium, loss of companionship and society, and loss of enjoyment in life.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
(11-a) “Mental or emotional pain or anguish” means 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.
 
(12) “Noneconomic damages” means damages awarded for the purpose of compensating a claimant for nonpecuniary losses for physical pain and suffering, mental or emotional pain or anguish, and [loss of consortium, disfigurement, physical impairment, loss of companionship and society, inconvenience, loss of enjoyment of life,] injury to reputation [and all other nonpecuniary losses of any kind other than exemplary damages]. The term does not include economic or exemplary damages.

(14) “Physical pain and suffering” means a 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.		(11-a) “Mental or emotional pain or anguish” means grievous and debilitating angst, distress, torment, or emotional suffering or turmoil that causes a substantial disruption in a person ’s daily routine. The term includes mental or emotional pain or anguish arising from loss of consortium, loss of companionship and society, loss of enjoyment of life, disfigurement, and physical impairment.
 
(12) Removed.

(14) A “Physical pain and suffering” means a 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, disfigurement, or impairment or is shown to exist through objectively verifiable medical evaluation or testing.

Change Four: The substitute intends to close the “incurred” loophole and prevent artificially inflated medical bills from influencing damage awards and limits the admissible evidence of healthcare expenses to the amount paid or the amounts that do not exceed 300% of the Medicare fee scheduled for the service.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 41.104. LIMITATIONS ON AMOUNT OF RECOVERY.

(a) In addition to any other limitation provided by law, the economic damages that may be awarded to a claimant for health care services provided in the past to an injured individual are limited to the sum of:

1) Amounts third-party payors paid to providers for health care services provided to the injured individual;

2) Amounts paid by the injured individual or paid on behalf of the injured individual by non-third-party payors to providers for health care services provided to the injured individual, but not to purchase an account receivable, 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 with the payor, injured individual, claimant, or claimant ’s attorney; and

3) If Subdivisions (1) and (2) do not apply, an amount that does not exceed 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 . . .

(b) In addition to any other limitation provided by law, economic damages awarded for health care expenses that in reasonable probability can be expected to be incurred by the injured individual in the future because of the injury-causing event shall be limited to the reasonable value of necessary services, determined in the manner provided by Subsection (a)(3) for determination of past health care expenses, except that the determination must use data from the database for the month preceding the date the trial commenced.		Sec. 41.104. ADMISSIBLE EVIDENCE OF HEALTH CARE EXPENSES.

(a) In addition to any other limitation provided by law, the evidence that may be offered to prove the amount of the economic damages that may be awarded to a claimant for health care services provided in the past to an injured individual is limited to evidence of:

1) Amounts third-party payors paid to providers for health care services provided to the injured individual;

2) Amounts paid by the injured individual or paid on behalf of the injured individual by non-third-party payors to providers for health care services provided to the injured individual, 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 with the payor, injured individual, claimant, or claimant ’s attorney; and

3) If Subdivisions (1) and (2) do not apply, amounts that, on the date each service was provided to the injured individual, do not exceed 300 percent of the Medicare fee schedule for the service.

(b) In addition to any other limitation provided by law, the evidence that may be offered to prove the amount of economic damages that may be awarded to a claimant for health care services that in reasonable probability can be expected to be provided to the injured individual in the future because of the injury-causing event shall be limited to evidence of the amounts of the reasonable value of necessary services, except that the amounts may not exceed 300 percent of the Medicare fee schedule applicable to each service as of the date the trial commenced.

Change Five: The substitute strikes the requirement that a failure to use available health insurance be considered a failure to mitigate damages.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 41.104. LIMITATIONS ON AMOUNT OF RECOVERY.

(d) The failure of the injured individual to use available health benefit coverage shall be considered a failure to mitigate damages.		Stricken.

Change Six: The substitute clarifies that the information disclosed pertaining to a claimant that was referred to a provider by their attorney shall be admissible into evidence, rather than all medical records obtained during discovery.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 41.107. MATTERS ADMISSIBLE INTO EVIDENCE.

In an action to which this subchapter applies, the following matters are admissible into evidence by any party:

A. A document or information provided, disclosed, or obtained under Section 41.105(a) or (b);

B. An injured individual ’s health care expenses incurred as a result of the injury-causing event, regardless of whether the claimant seeks to recover health care expenses in the action;

C. Evidence of health benefit plan coverage that is available to the injured individual to pay for past or future health care services; and

D. Treatment guidelines and drug formularies approved by the Workers’ Compensation Division of the Texas Department of Insurance as evidence relating to the necessity of health care services provided to the injured individual.		Sec. 41.107. MATTERS ADMISSIBLE INTO EVIDENCE.

In an action to which this subchapter applies, the following matters are admissible into evidence by any party:

A. A document or information provided by the claimant under Section 41.105(a);

B. If the injured individual was referred to a health care provider for services by the injured individual’s attorney and the provider will provide testimony that is presented to the trier of fact in the action, the information disclosed by the claimant under Section 41.105(b)(3)(C); and

C. Treatment guidelines and drug formularies approved by the Workers’ Compensation Division of the Texas Department of Insurance as evidence relating to the necessity of health care services provided to the injured individual.

Change Seven: The substitute strikes the provision that required a unanimous jury verdict for non-economic damages.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 41.151. STANDARDS FOR RECOVERY OF CERTAIN NONECONOMIC DAMAGES.

a) Damages for physical pain and suffering or for mental or emotional pain or anguish may be awarded only if the trier of fact is unanimous in finding the amount of money that will fairly and reasonably compensate the claimant for those injuries.		Stricken.

Change Eight: The substitute strikes the provision making it a reversible error for the court to allow for the characterization of an award as a valuation of life.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 41.151. STANDARDS FOR RECOVERY OF CERTAIN NONECONOMIC DAMAGES.

(c) In an action to which this chapter applies, it is reversible error for a court to allow an attorney, witness, or other person through argument, the introduction of evidence, or otherwise to:

1) State or suggest that the trier of fact should determine the amount of damages to award to a claimant for physical pain and suffering or mental or emotional pain or anguish by referring to objects, values, or repeating metrics having no rational connection to the facts of the case; or

2) Characterize an award of damages for physical pain and suffering or mental or emotional pain or anguish as establishing a valuation of human life.		Sec. 41.151. STANDARDS FOR RECOVERY OF CERTAIN NONECONOMIC DAMAGES.

(b) In an action to which this chapter applies, it is reversible error for a court to allow an attorney, witness, or other person through argument, the introduction of evidence, or otherwise to state or suggest that the trier of fact should determine the amount of damages to award to a claimant for physical pain and suffering or mental or emotional pain or anguish by referring to objects, values, units of time, or other matters having no rational connection to the facts of the case.

Change Nine: The substitute strikes the provision that allowed for remittitur upon a jury’s award of noneconomic damages past a certain threshold.

ORIGINAL SENATE BILL 30SENATE BILL 30 AS SUBSTITUTED
Sec. 41.153. MOTION TO REMIT NONECONOMIC DAMAGES IN CERTAIN ACTIONS.

(a) Except in an action in which another law limits recovery of noneconomic damages, in a trial to a jury in a personal injury or wrongful death action, a trial court shall state the legal and factual support for the amount of noneconomic damages awarded to a claimant in a judgment if a defendant requests remittitur of noneconomic damages awarded to the claimant and the award exceeds:

1) $1 million for past and future mental or emotional pain or anguish in a wrongful death action;

2) For past and future damages for physical pain and suffering in a personal injury action, the lesser of:

A. Three times the amount awarded for past and future health care expenses; or

B. $100,000 per year for each year of the claimant ’s life expectancy;

3) $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

4) $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.

(b) In a statement of legal support for the amount of noneconomic damages awarded in the judgment, the court shall include references to judgments rendered in this state and affirmed on appeal of comparable amounts awarded under comparable facts.		Stricken.

[1] House Bill 4806 was read for the first time in the House and referred to the Judiciary & Civil Jurisprudence Committee on April 3.