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TX HB985

TX HB985
Relating to hospital-owned outpatient facilities, including site-neutral reimbursement rates under Medicaid.


summary

Introduced
11/12/2024
In Committee
03/06/2025
Crossed Over
Passed
Dead
06/02/2025

Introduced Session

89th Legislature Regular Session

Bill Summary

AN ACT relating to hospital-owned outpatient facilities, including site-neutral reimbursement rates under Medicaid.

AI Summary

This bill establishes two key provisions related to hospital-owned outpatient facilities: First, hospitals are now required to provide written notification to the Texas Attorney General and the Health and Human Services Commission when they acquire an outpatient health care facility. Second, the bill mandates that Medicaid reimbursement rates for hospital-owned outpatient facilities must be equivalent to those of independent, physician-owned practices for certain outpatient services, specifically when the services do not rely on specialized facility technology and there is no evidence-based rationale for a different rate. Additionally, the bill requires the Texas Department of Insurance to conduct a study by September 1, 2026, examining the potential expansion of this site-neutral payment policy to commercial health benefit plan issuers, including an analysis of potential cost savings for healthcare consumers. The bill directs the Health and Human Services Commission to adopt necessary rules by January 1, 2026, and is set to take effect on September 1, 2025, with provisions allowing for federal waiver requests if needed for implementation.

Committee Categories

Health and Social Services

Sponsors (1)

Last Action

Referred to Human Services (on 03/06/2025)

bill text


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