All Roll Calls
Yes: 133 • No: 29
TexasHB 350589th Legislature Regular SessionHouse
Relating to the continuation and operation of a health care provider participation district created by certain local governments to administer a health care provider participation program.
Sponsored By: Cody Harris, Bryan Hughes (Republican)
Became Law
City Government--GeneralCounty Government--GeneralHealth Care ProvidersOpen MeetingsSpecial Districts & Authorities--HospitalState Finances--Management & ControlMEDICAIDHEALTH & HUMAN SERVICES COMMISSION
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 1 benefits, 0 costs, 4 mixed.
Patients protected from hospital payment surcharges
Hospitals paying into these district programs cannot add the required payment to a patient's bill as a surcharge. This protects patients from being charged that payment directly.
Closing hospital districts divides money and debts
Creating local governments must adopt identical orders to dissolve a district. The board then manages its property and assets and pays or settles its debts. Remaining provider-fund money goes back to institutional health care providers in proportion to their payments. Creating local governments share any debt shortfall based on their contributions. They also receive other unused money in those same proportions.
Hospital Medicaid funding gets use limits
Districts must keep hospital payments and related receipts in a separate fund, including remaining money from the old program. The fund supports state transfers that draw federal matching money for nonpublic hospitals. Approved payments include uncompensated care, uniform managed-care rate increases, similar waiver payments, and other federally matched reimbursements. Other allowed uses are capped program costs, refunds of payments collected by mistake, and proportional hospital refunds of unusable state-returned money. Districts can collect only what is reasonably needed for approved uses, and only while a listed funding option is available. Money resulting from these transfers cannot fund Affordable Care Act Medicaid expansion; this does not itself change who qualifies for Medicaid. Boards can replace rules that block federal matching, but cannot add or materially expand district or provider liability. Texas health officials can reject fund money when accepting it may violate federal law.
Local hospital districts continue with oversight
Qualifying districts can continue their hospital funding programs when their prior authority expires. Each creating local government must approve identical orders, and the district board must ratify them. Eligible governments are counties with more than 80,000 but fewer than 90,000 people bordering the Trinity River; counties with more than 45,000 but fewer than 55,000 people bordering Oklahoma; or hospital districts in counties with more than 30,000 people containing part of Jim Chapman Lake. With three or more governments, each appoints one director. With two, the more populous government appoints two directors and the other appoints one. Directors serve staggered two-year terms, must live in the appointing jurisdiction, and cannot be district employees. Directors serve without pay but can receive actual expense reimbursements. Districts must hold public hearings at least yearly on proposed payments and spending, with notice to hospitals and the public. Hospitals must submit required financial and use data, and districts must report collections, spending, and administrative contracts to state health officials. Districts cannot issue bonds.
Required hospital payments have firm caps
Covered nonpublic hospitals must make annual payments based on net patient revenue, with assessments no more often than quarterly. Payments must use a uniform share of revenue and be updated yearly. First-year amounts use the latest reported state data, or Medicare cost reports when required state data is missing. Total payments cannot exceed 6% of all paying hospitals' combined net patient revenue. Payments must cover approved transfers and administration, but administrative use is capped at $150,000 yearly plus actual deposit-security costs. Hospitals cannot be charged under both the old and new district programs for the same period. Collection fees cannot exceed usual charges for similar work; fees collected by district officials go to the district's general fund. Late-payment interest and penalties cannot exceed the limits for other overdue payments owed to the creating local governments.
Sponsors & Cosponsors
Sponsors
Cody Harris
House
Bryan Hughes
Republican • Senate
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 5/25/2025
Record vote
Yes: 0 • No: 0
Senate vote • 5/25/2025
Record vote
Yes: 0 • No: 0
House vote • 5/6/2025
Record vote
Yes: 118 • No: 28
House vote • Unknown
Committee vote: Intergovernmental Affairs
Yes: 8 • No: 1
Senate vote • Unknown
Committee vote: Local Government
Yes: 7 • No: 0
Actions Timeline
Effective immediately
6/20/2025HouseFiled without the Governor's signature
6/20/2025HouseSent to the Governor
5/28/2025HouseSigned in the Senate
5/27/2025SenateSigned in the House
5/27/2025HouseReported enrolled
5/26/2025HouseSenate passage reported
5/25/2025HouseRecord vote
5/25/2025SenatePassed
5/25/2025SenateRead 3rd time
5/25/2025SenateRecord vote
5/25/2025SenateThree day rule suspended
5/25/2025SenateVote recorded in Journal
5/25/2025SenateRead 2nd time & passed to 3rd reading
5/25/2025SenateLaid before the Senate
5/25/2025SenatePlaced on local & uncontested calendar
5/25/2025SenateCommittee report printed and distributed
5/16/2025SenateRecommended for local & uncontested calendar
5/16/2025SenateReported favorably w/o amendments
5/16/2025SenateVote taken in committee
5/15/2025SenateConsidered in public hearing
5/15/2025SenateLeft pending in committee
5/12/2025SenateConsidered in public hearing
5/12/2025SenateScheduled for public hearing on . . .
5/12/2025SenateReferred to Local Government
5/7/2025Senate
Bill Text
Engrossed
Enrolled
House Committee Report
Introduced
Senate Committee Report
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