Texas CPRC § 18.001 Medical Billing Affidavits & Controverting Counter-Affidavits (In re Allstate)
Summary of the Texas Rule (Tex. Civ. Prac. & Rem. Code § 18.001)
Provides a streamlined statutory affidavit procedure to prove that past medical charges were reasonable in amount and medically necessary without calling live physicians at trial—unless controverted.
Statutory Text Summary & Legal Mechanics
Under Section 18.001(b), unless a controverting affidavit is timely served, an affidavit by a health care provider or records custodian stating that the service was necessary and the amount charged was reasonable is sufficient evidence to support a jury finding. Under § 18.001(d), the plaintiff must serve § 18.001 affidavits by the earlier of 90 days after the defendant files its answer or the plaintiff's expert designation deadline, and the defendant has 120 days (or 30 days after the affidavit) to serve a controverting counter-affidavit.
Practical Impact on Texas Personal Injury Claims & Jury Trials
In In re Allstate Indemnity Co., 622 S.W.3d 870 (Tex. 2021), the Texas Supreme Court revolutionized § 18.001 practice by holding that: (1) a qualified medical coding/billing auditor can author a counter-affidavit on billing reasonableness; and (2) even if a defendant fails to serve a valid § 18.001 counter-affidavit, the defendant is still permitted to cross-examine and call live experts at trial to challenge reasonableness and necessity!
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