THA is now neutral on a key House bill that originally sought particularly severe restrictions on hospital facility fees. President and CEO John Hawkins testified on House Bill 2556 last week, thanking the bill’s author, Rep. James Frank, for working with THA on a committee substitute for the bill. Notably, the latest version of HB 2556 removes the ban on facility fees for preventive care, among other key changes. However, Hawkins’ testimony noted concerns from THA members about certain parts of the committee substitute, including a 90-day notice requirement before a hospital can charge a facility fee for a new provider location. Other testifying organizations included the Teaching Hospitals of Texas, which testified in favor of HB 2556, and Memorial Hermann Health System, which testified against it.

A poignant hearing Wednesday on House Bill 2854 included testimony from Jim Scoggin, CEO of Methodist Dallas Medical Center – the site of an October 2022 shooting in which two people were killed. That tragic event prompted HB 2854 by Rep. Rafael Anchía, which requires hospital notification before parolees who are under mandatory electronic monitoring may visit hospitals. In the House Committee on Corrections hearing, Hawkins testified for THA supporting this bill, and Stephen Love, CEO of Dallas-Fort Worth Hospital Council, spoke in support as well.

Several other hospital-relevant bills were heard Thursday afternoon, just before press time. These include House Bill 1635 to reinforce the prudent layperson standard for emergency care, and House Bill 2036 to bolster the continuum of behavioral health care in Medicaid by requiring coverage for partial hospitalization and intensive outpatient therapy. THA stands in strong support of both of these measures.

THA and the Texas Medical Association join forces to advocate for saving pregnant mothers’ lives. This is the Cap Recap for April 14, 2025.

During the early part of last week, THA joined another of the state’s most influential health care trade groups to throw united support behind one of the most consequential and highest-profile bills of this state legislative session: the Life of the Mother Act. In a joint release with the Texas Medical Association, THA detailed why it’s fully backing House Bill 44 and Senate Bill 31, which clarifies the medical emergency exception to Texas’ abortion ban. THA and TMA believe the bill – which clarifies that a pregnant mother’s death does not need to be imminent for a physician to terminate a pregnancy in a medical emergency situation – will save not only lives, but future fertility for Texas moms.

On Monday morning, THA testified in support of the legislation during a marathon House Public Health Committee hearing on House Bill 44. Associate General Counsel Heather De La Garza-Barone said the bill would help physicians treat pregnant patients without fear of criminal prosecution or civil liability. The Life of the Mother Act is priority legislation for Lt. Gov. Dan Patrick.

Along with that key bill, THA also testified in support of a key measure to protect safety-net hospital access to the 340B Drug Pricing Program. House Bill 3265 by Rep. Drew Darby also yielded testimony of support from several THA member hospitals, including Dr. Esmaeil Porsa, president and CEO of Harris Health. Dr. Porsa told the House Insurance Committee that 70% of his system’s patients take Medicaid or are uninsured, and that the 340B program is a lifeline for Harris Health. De La Garza-Barone also delivered THA’s testimony on HB 3265, attempting to alleviate concerns about the cost of the program by noting that a minority of Texas hospitals participate.

THA President and CEO John Hawkins testified Wednesday to support House Bill 2750, which would require insurers that use a pharmacy benefit manager to give consumers the option of using a PBM in which the insurer doesn’t have a financial stake. THA believes the bill will help drive down both prescription costs and the overall cost of health care.

Not every bill THA testified on in committee last week has the support of hospitals. THA appeared Wednesday in the Senate Health & Human Services Committee to oppose Sen. Bill 407 by Sen. Mayes Middleton, which would prohibit health care facilities from rejecting a vaccine exemption based on reasons of conscience, meaning hospitals could not reject the exemption for any reason. THA Associate General Counsel Nicole Lusardi invoked the current measles outbreak in West Texas to illustrate the danger of the bill, and said it would open the door to more outbreaks, worsened health care staffing shortages and higher labor costs.

Also drawing opposition in committee from THA was House Bill 2747 by Rep. James Frank, which would require new, broad reporting for hospitals that undertake a material change transaction, a term that encompasses such business transactions as ownership or governance changes. General Counsel Steve Wohleb noted that hospitals are already heavily regulated, and HB 2747 would add yet more reporting burdens to their plate.

That’s it for this week. Join us again next Monday for the latest from downtown Austin.

THA’s week at the Capitol featured defenses of baseline-level hospital needs – including a hospital’s ability to protect its reputation. Senate Bill 2043 by Sen. Bryan Hughes contains anti-retaliation protections for health care workers who report illegal or unethical activity, or patient care issues. But the bill would also prohibit health care facilities from taking any adverse action against employees for speech protected by the First Amendment – which, of course, only protects a person from government punishment for speech.

In testimony to the Senate State Affairs Committee, THA General Counsel Steve Wohleb explained that SB 2043 would bar hospitals from taking any action against a physician, or other employee, who mars the hospital’s personal brand or image – such as by posting a racist rant about their patients on social media. That hamstringing of a hospital’s reputation management is driving THA’s opposition to SB 2043. As for the health care whistleblower protections in the bill, Wohleb’s testimony noted such protections already exist in the state Health & Safety Code.

Earlier in the week, THA testified neutral, but with concerns, on a health care liability reform bill that would limit the recovery of medical expenses in a lawsuit. Senate Bill 30 by Sen. Charles Schwertner gives the Legislature the authority to define the reasonableness of medical expenses based on an arbitrary external benchmark. Wohleb also testified on this bill, telling the State Affairs Committee that many unique factors influence a given hospital’s charges, and THA maintains that outside of government payers, market forces – not the Legislature – should determine the reasonable value of health care services. THA is also concerned with language in SB 30 that could introduce burdensome, time-consuming discovery and testimony requests for providers involved in liability cases.

Financial considerations – and burdensome mandates – also factored into THA’s testimony on House Bill 1314 by Rep. Hillary Hickland. The bill would require providers to furnish a price estimate to patients within 24 hours after a patient requests one, and would also generally prohibit the final billed charges from exceeding that estimate by more than 5%. THA Associate General Counsel Heather De La Garza-Barone testified on the bill with concerns, proposing a more reasonable time frame of five business days to produce the requested estimate. She also detailed the administrative challenges hospitals would face in staying within 5% of the price estimate.

In the Senate Health and Human Services Committee, THA testified against Senate Bill 1608 by Sen. Donna Campbell, which would require every patient admitted to a mental health facility to undergo an in-person physical examination, by a physician, upon admission. Current law provides a 24-hour window to perform such an examination, and also allows for the exam to be performed through telehealth. Wohleb said while an in-person exam is preferred, an initial examination by telehealth is useful because of difficulties some hospitals have in achieving physician coverage at certain times.

A separate mental health-related measure was one of several THA-supported bills that made it out of committees last week. House Bill 3163 by Rep. Jeff Leach would clarify parameters of the process to obtain an order of protective custody so that a patient who is a danger to themselves or others can receive the time-sensitive mental health services they need. That bill is now eligible for consideration by the full House. Also clearing committee this week were House Bill 37, which establishes standards and a grant program for hospital perinatal palliative care, and Senate Bill 1822, which would regulate and introduce transparency requirements for the use of artificial intelligence in insurer utilization reviews.

Activity abounded in Austin last week as lawmakers on both sides of the Capitol examined and advanced legislation with health care implications, and THA staff appeared repeatedly in committee hearings to offer hospitals’ input on impactful bills.

Providers frustrated with reports in recent years of health insurers using artificial intelligence to make claims decisions got good news this week, as THA-supported Senate Bill 815 passed the full Senate. SB 815 bars insurance companies from using an AI algorithm as the sole basis for denying a claim in utilization review, and also states that only a health care provider may determine medical necessity or appropriateness. That bill now heads to the House for consideration.

THA Associate General Counsel Heather De La Garza-Barone testified three times last week, including remarks in support of Senate Bill 31, an abortion clarification bill listed as a priority for Lt. Gov. Dan Patrick. SB 31, known as the Life of the Mother Act, would provide clarity on when a physician may terminate a pregnancy under the limited exception to Texas’ abortion ban. The bill would eliminate the current confusion that exists with four different abortion statutes in Texas law, and would reinforce that the pregnant woman’s life does not need to be in imminent danger for the life-of-the-mother exception to apply. De La Garza-Barone told the Senate State Affairs Committee that SB 31 would allow hospitals to support the treatment of pregnant patients without fear of either criminal or civil liability.

De La Garza-Barone also represented THA in the House Public Health Committee to support House Bill 2187 – an update of the state’s landmark 2009 nurse staffing laws – and in the House Insurance Committee to oppose House Bill 139, which would allow employers to offer basic health plans that don’t meet state-mandated standards. The THA-negotiated House Bill 2187 would account for changes in the health care landscape since 2009 – such as the ongoing hospital workforce shortage – to make sure the nurse staffing law is working as intended, and also prohibit retaliation against nurses who report violations of staffing and mandatory overtime laws. THA is working with the author of House Bill 139, Rep. Jay Dean, to improve the notice requirements for what the bill calls “employer choice of benefits” health plans. These plans would not meet all the requirements of state-mandated benefits, but would be required to meet the “essential health benefits” regulations tied to the Affordable Care Act.

In other THA appearances in committee testimony this week:

• Associate General Counsel Nicole Lusardi testified to support a THA priority measure, House Bill 3163, which would clarify protocols on obtaining orders of protective custody for a person who is a danger to themselves or others;
• Steve Wohleb, THA’s general counsel, spoke in opposition to Senate Bill 1318, a bill to restrict physician noncompete agreements using limits on both time and geographical distance; and
• THA President/CEO John Hawkins testified to support House Bill 1327, which would renew local provider participation funds for Harris County for two years.

In other key movement on bills this week, the full Senate gave its approval to Senate Bill 1018, which increases the percentage of state-collected traffic revenue that will be allocated to the state’s designated trauma facility and emergency medical services account; and the House Insurance Committee approved House Bill 1142, a measure to mandate parity for mental health coverage in group health plans. However, the Senate Health and Human Services Committee advanced several THA-opposed bills. These include Senate Bill 619 – which generally allows providers to opt out of performing a service for reasons of conscience – and Senate Bill 660, which would mandate crash barriers at all hospital emergency departments near vehicular traffic.

THA General Counsel Steve Wohleb stepped up for hospitals last week at the Texas Capitol, giving strong testimonies against two bills heard by the Senate Committee on Health and Human Services. One of these bills, Senate Bill 619 by Sen. Kevin Sparks, would generally allow health care providers to opt out of administering any health care service for reasons of conscience. Wohleb told the committee that allowing health care workers to opt out from their duties could exacerbate existing workforce shortages, as hospitals already are struggling to find qualified staff.

Required crash barriers at emergency departments were also a topic in Health and Human on Tuesday as the same committee took up THA-opposed Senate Bill 660 by Sen. Royce West. With Wohleb again taking the microphone, THA spoke out against SB 660, which would require crash barriers – also known as bollards – at ERs located near vehicular traffic. Despite last year’s highly publicized vehicle crash at an Austin medical center that resulted in the death of the driver and five other injuries, Wohleb noted that available data show hospitals are only a fraction of vehicle crashes into businesses. His testimony stressed that singling out hospital ERs for a bollard mandate could have a negative impact on patient care because of the financial burden that obtaining crash barriers would create for many facilities.

THA’s legal team also raised concerns about proposed new electronic health record requirements as Associate General Counsel Nicole Lusardi testified Tuesday on Senate Bill 1188 by the chair of the Health and Human Services Committee, Sen. Lois Kolkhorst. Financial and operational burden is once again a point of concern for hospitals in that bill. For example, SB 1188 requires medical facilities to store their EHR information only in the United States. Lusardi noted that requirement would particularly hurt smaller and rural hospitals, who would be forced into using domestic data storage – which is often more expensive than internationally based data storage. THA is working on the bill’s language with Sen. Kolkhorst.

Capping THA’s testimony last week was President and CEO John Hawkins, who appeared in the House Insurance Committee on Wednesday to oppose House Bill 138 by Rep. Jay Dean. HB 138 would create a state Health Impact, Cost and Coverage Analysis Program, which would perform cost and utilization analyses on legislation that would introduce new mandates on health insurers. Hawkins said the bill, as filed, would fail to take into account health care benefits from the legislation assessed by the new program. THA has submitted language to the bill’s author that would attempt to create a more comprehensive picture on a given bill’s impact on the health care system.

THA strives to make sure investigations of fraud and abuse in Medicaid are fair. This is the Cap Recap for March 17, 2025.

THA testified twice last week in the Texas Senate’s Committee on Health and Human Services, including an appearance to register concerns on a bill to crack down on Medicaid fraud. THA General Counsel Steve Wohleb testified last Tuesday on Senate Bill 1038, which would expand the number of specific ways in law that a provider could be found to have committed fraud and abuse. For example, the bill would explicitly crack down on providers who knowingly commit such acts as making false statements tied to a patient’s benefits, or obstructing an investigation by the Office of the Inspector General, which probes fraud, waste and abuse.

Wohleb cautioned against bringing strict criminal punishment into play for honest mistakes, such as billing errors, and also expressed THA’s concern with SB 1038’s appeal process. The bill appears to move provider appeals of decisions away from independent reviews at the State Office of Administrative Hearings, instead sending appeals through the Texas Health and Human Services Commission. Wohleb expressed concern that the deck could be stacked against a provider accused of wrongdoing.

On Wednesday, the same committee examined a bill to allow patients to supply their own blood – or someone else’s that they know – for a transfusion or other procedure. THA opposed the filed version of Senate Bill 125, which would require licensed hospitals to except autologous or direct blood donations. THA Associate General Counsel Nicole Lusardi noted most Texas hospitals don’t have the infrastructure to collect blood, which is an FDA-regulated practice, and also objected to the inadequate 72-hour blood collection and processing window outlined in the bill. Sen. Hall noted a committee substitute for the bill was forthcoming that would limit the blood collection requirement to facilities that already are capable of collecting donations.

THA dropped a card in support for other bills the Health and Human Services Committee examined last week. Hospitals are supporting Senate Bill 599, which would ban political subdivisions from imposing health and safety standards on licensed childcare or registered family homes that exceed state standards. THA also registered support for Senate Bill 896 to extend required newborn coverage to 60 days post-birth for several different types of health plans. Currently, coverage is required for 31 days post-birth.

That’s all for this week. Tune in next Monday for another update from Austin.

Although THA didn’t testify in any committee hearings at the Texas Capitol last week, it stayed on top of bills being heard in committee that hold implications for hospitals. The Senate Health and Human Services Committee examined multiple bills fitting that description, and THA registered support for one of those, Senate Bill 916 by Sen. Judith Zaffirini. The bill would provide consumer protections against overbilling by emergency medical services providers.

The same committee also examined Senate Bill 1122 by Sen. Charles Schwertner, MD, a measure THA is keeping close tabs on. The bill attempts to clarify that pharmacy benefit managers handling employer-sponsored, self-funded health plans – which are governed under federal law – are still beholden to state law as well. SB 1122 would require PBMs to comply with state insurance law for any health plan the PBM operates, unless that plan is specifically excluded in the law.

While that was happening in Austin, THA’s key face time this week occurred in Washington, D.C., where staff met with the offices of more than a dozen members of the Texas congressional delegation. During these office visits, THA stressed the importance of several outstanding issues that must be resolved by April 1, including pending cuts to Medicaid Disproportionate Share Hospitals that would cripple Texas’ safety net. THA is asking for those cuts to either be delayed once again, or outright repealed. Among other programs, April 1 would also bring the end of two vital rural hospital payment sources – the Medicare-Dependent Hospital and Low-Volume Adjustment programs – if Congress doesn’t take action to renew them. The likely legislative vehicle for these must-pass items is another continuing resolution to fund the federal government. The current funding package expires on March 14.

THA’s visit to Washington also featured discussions with congressional members and their staffs about the impact of drastic budgetary reforms that have been raised in talks over a major package to address border security, energy and taxes. The Texas Medicaid program is staring down multiple avenues of major funding cuts in these talks, including restrictions on state directed payment programs. A new explainer document, available on the White Papers and Reports page at tha.org, details the implications of these proposals, as well as the items that need action by April 1.

It was a busy week at the Capitol for THA President and CEO John Hawkins, who testified before two Texas House Appropriations subcommittees examining key hospital-related funding for the 2026-2027 state budget. In Wednesday’s hearing of the Subcommittee on Article II, covering the health and human services budget, Hawkins registered THA’s support for the current House funding proposal in that article, complimenting its full funding of Medicaid client services based on caseload projections and money allocated to fund more women’s health mobile units. Hawkins asked for more help in the crucial realm of behavioral health, including requesting the first pay rate increase for behavioral health since 2008 and coverage of “step-down” services in Medicaid, such as partial hospitalization.

On Tuesday, Hawkins appeared before the subcommittee handling the higher education budget, Article III. While praising current funding to help clear the state’s workforce pipeline, he asked for the legislature to fund the clinical-site training programs established two years ago by a major, THA-supported nursing workforce bill, Senate Bill 25. THA is requesting funding for a nurse preceptorship grant program, a nursing faculty grant program and a clinical-site innovation and coordination program.

Preventing health insurer misuse of artificial intelligence was a topic of meaty discussion on Thursday in the Senate Business & Commerce Committee, where the Texas Coalition for Patients – which includes THA – testified in support of a committee substitute version of Senate Bill 815. That bill by Sen. Charles Schwertner would bar insurers from using AI algorithms as the sole basis to deny medical claims in utilization review. Katherine McLane testified for the coalition, telling the Business & Commerce Committee that the bill ensures that AI won’t be used for unethical interference in clinical decision-making. Sen. Schwertner, the committee’s chair, said that for too long, insurers have hidden behind automation to put their bottom line above patient care.

Following the recent announcement of committee assignments in the Texas House of Representatives, that chamber has now joined the Senate in scheduling committee hearings. That means the legislative process will pick up quickly from here, and THA is hopeful that pieces of its top-priority legislation will soon be referred to committee and begin the long and complex march to becoming law.

As THA continues to track bill movement and other happenings at the Capitol, here’s a quick look at a handful of Texas hospitals’ top-line bills so far.

Behavioral health is once again an elevated priority this year, and THA is supporting key bills to both improve behavioral health coverage and bring mental health facilities up to date. House Bill 2036 by Rep. Tom Oliverson represents the latest push to require coverage of partial hospitalization programs and intensive outpatient therapy in Medicaid. Requiring these “step-down services would improve the behavioral health continuum of care, aligning it with the spectrum of services that exists for physical care.

HB 2036 does not yet have a Senate companion bill, but a THA bill for technological enhancements at mental health facilities is already filed in both chambers. House Bill 1621 by Rep. John Lujan and Senate Bill 151 by Sen. José Menéndez would institute matching grant programs to make these tech improvements. Hospitals that qualify would kick in 25% of the allotted grant amount from non-state sources.

Along with his bill to improve behavioral health coverage, Representative Oliverson is also running point in the House on the effort to strengthen the prudent layperson standard for emergency care. His House Bill 1635 would explicitly state that insurers can’t deny coverage for an emergency-room encounter based on the patient’s final diagnosis. This bill would fully reinforce that coverage for ER visits would be based on whether a prudent layperson – with an average knowledge of medicine – would believe the patient’s condition was an emergency. The companion bill for HB 1635 is Senate Bill 622 by Sen. Charles Schwertner.

With stories of major health insurers’ questionable use of artificial intelligence making headlines in the past few years, THA is also backing a bill to make sure robots aren’t replacing the expertise and judgment of health care providers. House Bill 2922 by Rep. David Spiller and Senate Bill 815 by Sen. Schwertner would prohibit AI algorithms from being used as the sole basis to deny a claim in insurer utilization reviews, and would state that only a physician or other health care provider may determine medical necessity or appropriateness.

This coming week, with House Appropriations subcommittees set to examine key parts of the budget, THA President and CEO John Hawkins plans to deliver testimony on both the health and human services part of the budget and the higher-education portion. The subcommittee on Article III – the budget section for the Texas Higher Education Coordinating Board – is scheduled to meet and take testimony on Tuesday morning. On Wednesday, the subcommittee for Article II – health and human services – is scheduled to receive public testimony.

Legislative activity at the Texas Capitol should pick up speed in a hurry now that both chambers have their committees in place. On Thursday, House Speaker Dustin Burrows filled in the last key piece of the puzzle, announcing committee assignments for that chamber. As stipulated in House rules for this session, all committee chair spots are held by Republican members, and Democrats occupy each committee’s vice chair position.

For hospital and health care advocates, a handful of committees and their leadership bear the most watching as session unfolds. Key committee chairs include Rep. Gary VanDeaver, who will lead the House Committee on Public Health; Rep. Jay Dean, chair of the Committee on Insurance; and Rep. Lacey Hull, chair of the Committee on Human Services. Once again, the powerful Committee on Appropriations – which oversees the crafting of the state’s two-year budget – will be chaired by Rep. Greg Bonnen, a Friendswood physician.

The Committee on Public Health is fielding a Standing Subcommittee on Disease Prevention and Women and Children’s Health, another panel that THA will follow closely. Rep. James Frank will chair this key subcommittee, and Rep. John Bucy III will serve as vice chair. Other members of the five-person subcommittee include Reps. Charles Cunningham, Ann Johnson and Katrina Pierson.

Across the Capitol, testimony continued last week in the Senate Finance Committee on various aspects of the budget. THA President/CEO John Hawkins submitted written testimony on the Texas Workforce Commission budget on Wednesday, highlighting THA’s support for the Jobs and Education for Texans program. The program has helped train more than 34,000 health care practitioners and produced an economic impact of nearly $619 million. Hawkins’ comments also noted THA has joined Employers for Childcare, a coalition advocating for targeted grants, streamlined regulations and other initiatives to increase access to care for young children.

With budget discussions in their early stages at the Texas Capitol, THA made its first appearances on committee witness rosters this week, making sure lawmakers in the Senate Finance Committee keep health care funding in the center of their radar.

THA President/CEO John Hawkins testified before the committee on Tuesday to represent hospitals in discussions on the Health and Human Services section of the budget, and appeared in front of the committee again on Wednesday to address higher education.

His testimony Tuesday focused on encouraging robust funding for many key tenets of health and human services, including:

• Medicaid funding for behavioral health;
• Key Medicaid add-on payments;
• Women and children’s health services; and
• Rural hospital stabilization grants.

Through Hawkins’ testimony, THA also co-signed on funding requests by the Texas Department of State Health Services to improve maternal and child health data and combat the recent rise in congenital syphilis cases. In the initial 2026-27 budget proposals recently released by both the House and Senate, funding for key Medicaid, behavioral health and workforce items remained mostly level as compared to the current biennium.

In Hawkins’ return to the Capitol on Wednesday, he expressed support for the level funding the current budget bills allocate for several important hospital workforce pipeline programs. These include the Mental Health Professionals Loan Repayment Program – which would again receive $28 million over two years in the current budget proposals – and the Nurse Faculty Loan Repayment Program, which would receive $7 million across 2026 and 2027. Importantly, THA also advocated for lawmakers to fund the clinical-site nurse training programs instituted as part of Senate Bill 25 during the 2023 legislative session. That nursing workforce bill was one of hospitals’ signature achievements two years ago.

Before the week’s hearings at the Capitol, Gov. Greg Abbott laid out his directions for the Legislature in his annual State of the State address. Abbott’s speech on Feb. 2 advocated for expanded funding and access to care for mental health, especially in the rural parts of the state. He also included the creation of a Texas Cyber Command as one of his emergency items for this session, noting recent cyberattacks against a Texas hospital and other entities.