TX HB3321

Prohibits health care entities and systems from charging facility fees for services provided outside their campus or for outpatient evaluation and management procedures regardless of location

Requires health care entities that charge facility fees to provide patients written notice at appointment scheduling about potential fees, cost ranges, complaint procedures, and available financial assistance programs, and to post multilingual signs about facility fees

Mandates that newly affiliated health care entities notify patients who received services in the prior 12 months about the affiliation and cannot charge facility fees until 30 days after providing notice

Requires each health care entity to obtain unique national provider identifiers for each campus and off-campus location, include these identifiers on all bills and claims, and use proper CMS forms for off-campus services—patients and insurers are not required to pay non-compliant claims

Establishes enforcement through Health and Human Services Commission audits, administrative penalties of at least $1,000 per violation, license revocation or suspension, and treatment of violations as deceptive trade practices under the Business & Commerce Code, with rules required by January 1, 2026