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2025 · Regular session · Senate bill
SB984
SB984 creates a Texas access framework for experimental treatments made exclusively for one patient based on that patient’s genetic profile.
Official caption: Relating to access to individualized investigational treatments for patients with life-threatening or severely debilitating illnesses.
Official report lists Senate author(s): Bettencourt. This does not identify sponsors or amendment drafters.
Bill explanation published · Version and amendment review scope is stated below · Individual amendment records may not be separately annotated.
Bill highlights
Selected points from the published explanation. Follow each point to its source-linked context; conditions and limits may matter.
- SB984 creates a Texas access framework for experimental treatments made exclusively for one patient based on that patient’s genetic profile.
- A patient must have a life-threatening illness or an illness causing major irreversible harm, have considered all FDA-approved treatment options, and give written informed consent.
- Consent must identify the treatment, explain approved alternatives, and include the patient’s agreement with the physician’s assessment that approved and conventionally recognized treatments are unlikely to prolong life.
- Manufacturers need not supply treatment.
What does it do?
SB984 creates a Texas access framework for experimental treatments made exclusively for one patient based on that patient’s genetic profile. It covers individualized drugs, biological products and devices, including specified gene therapies and vaccines. The governor signed it May 29, 2025; it took effect September 1, 2025. History; Final law, new Chapter 491.
A patient must have a life-threatening illness or an illness causing major irreversible harm, have considered all FDA-approved treatment options, and give written informed consent. The physician must attest to eligibility and recommend the treatment based on the specified genetic or molecular analysis. A facility must operate under a federal assurance for protecting human research subjects and be subject to the applicable assurance requirements. A manufacturer must operate within an eligible facility and comply with applicable federal assurance laws and regulations. This is not a general authorization for any experimental product at any clinic. Final law, new Chapter 491, sections 491.001 and 491.051–.054.
Consent must identify the treatment, explain approved alternatives, and include the patient’s agreement with the physician’s assessment that approved and conventionally recognized treatments are unlikely to prolong life. It must explain potential best, worst and most likely outcomes, including unexpected or worse symptoms and hastened death; possible loss and reinstatement of hospice eligibility; and financial responsibility. The physician and a witness must attest in writing. For a minor or a patient lacking mental capacity, a parent, guardian, managing conservator or authorized medical-power-of-attorney agent may consent. Final law, new Chapter 491, section 491.053; Definition of agent.
Manufacturers need not supply treatment. Facilities and manufacturers may supply it free or charge manufacturing-related costs; hospitals need not add services without their approval. State officials may not block compliant access, but medically appropriate advice or recommendations remain allowed. A provider’s recommendation alone cannot justify state licensing sanctions or adverse Medicaid-participation action. Final law, new Chapter 491, sections 491.054, .057, .103 and .151.
What changed along the way?
The introduced, Senate committee, engrossed, House committee and enrolled versions contain the same operative provisions. The official index lists no floor amendments. The law adds Chapter 491; its protections are limited to the eligible patients, treatments, facilities and conduct described there. Five text versions; Amendment index; Final law, new Chapter 491.
For the full amendment record, open the official amendment index.
Official bill versions
Compare the published text versions in the official text index. A change is not attributed to a specific amendment here without a verified record.
Who could benefit—and who could bear the costs?
Eligible patients and physicians gain a state-law framework for requesting these individualized treatments, but access, benefit and affordability are not guaranteed. The law does not require health plans, administrators or government agencies to pay. It preserves existing insurance coverage requirements and clinical-trial coverage under Insurance Code Chapter 1379. Consent must disclose that payment is not obligatory unless required by law or contract, and that the patient’s expense liability extends to the estate unless the manufacturer contract provides otherwise. If the patient dies during treatment, heirs are not liable for the outstanding treatment-related debt or lack of coverage. The estate and heirs are therefore not interchangeable in this law. Final law, new Chapter 491, sections 491.053–.055 and .101–.104.
The chapter creates no private cause of action for treatment-related harm against manufacturers or others involved in care when they comply in good faith and exercise reasonable care. That wording is not a blanket declaration that all malpractice claims disappear. The consent warning also recognizes that treatment may cause harm or hasten death; the act is not evidence of effectiveness. Final law, new Chapter 491, sections 491.053 and .056.
The March 17 fiscal note anticipates no significant state or local fiscal impact and assumes state implementation costs can be absorbed with existing resources. It does not estimate a patient’s treatment bill or promise insurance reimbursement. Sole indexed fiscal note.
Official sources
- Bill history and latest recorded action
- Bill versions, analyses and fiscal notes
- Action history and votes
- Amendment index
Catalog report retrieved 2026-10-25. Check the official record for corrections or later changes.
