HB 3708

relating to charity care provided by certain health care
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Subchapter D, Chapter 311, Health and Safety
Code, is amended by adding Section 311.0454 to read as follows:
Sec. 311.0454.  CHARITY CARE SCREENING.  (a)  Using the
process prescribed by the commission under this section, a
non-disproportionate share hospital shall screen all patients for
eligibility of the hospital's financial assistance program and
charity care policy.  A hospital cannot pursue debt collections of
any patient account until the hospital verifies the patient is not
eligible for the hospital's financial assistance program and
(b)  The executive commissioner of the Health and Human
Services Commission shall adopt by rule the process for screening a
patient for eligibility for charity care under Subsection (a).
(c)  The rules and process adopted under Subsection (b) must
(1)  before sending a bill to the patient, to conduct
the screening and apply any charity care discounts or full cost
coverage for which the patient qualifies for; and
(2)  include on each billing statement notice of:
(A)  the availability of financial assistance;
(B)  the contact information for the office or
department of the hospital that can provide information about
obtaining financial assistance; and
(C)  the direct Internet address for the financial
(d)  A patient may apply for charity care if the patient was
screened for eligibility and was found not to be eligible or the
patient disagrees with the amount of the charity care discount.
(e)  If a hospital makes an incorrect determination under
Subsection (a) based on the information provided by the patient at
the time of the determination, the hospital shall:
(1)  refund the amount of charity care for which the
(2)  reimburse any other associated reasonable costs,
such as legal expenses and fees, incurred by the patient in securing
(f)  If the hospital sold debt based on an incorrect
determination to a collection agency or authorized a collection
agency to collect the debt on behalf of the hospital, the hospital
shall notify the collection agency that the debt is invalid.
(g)  If the commission determines that a hospital fails to
(1)  upon the first violation, the commission shall
institute a corrective action plan for the hospital and post it on
the commission's internet website;
(2)  upon the second violation:
(A)  the commission shall apply an administrative
penalty of not less than $250,000; and
(B)  apply a probationary of period of not more
than 90 days, after which the commission shall confirm that the
hospital is in compliance with this section; and
(3)  upon the third violation, the commission shall
inform the attorney general of the nature of the non-compliance,
who shall bring an action in the name of this state to revoke the
hospital's state tax exemptions.
SECTION 2.  311.045, Health and Safety Code, is amended by
adding Subsection (g) to read as follows:
(g)  When calculating net patient revenue under this
section, a hospital or hospital system shall include all facilities
and practices offering medical services located in this state under
the common governance of a single corporate parent, regardless of
their radius from that corporate parent.
(h)  All facilities described by Subsection (g) must comply
with charity care screening requirements found in by Section
SECTION 3.  This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution.  If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2025.