TX HB3708

Nonprofit hospitals and hospital systems must include revenue from all Texas-based facilities and practices under common corporate governance when calculating net patient revenue for charity care requirements, excluding facilities designated as disproportionate share hospitals under Medicaid

Nonprofit hospitals must inform and screen every patient for eligibility for the hospital's financial assistance and charity care program before sending billing statements, and cannot pursue debt collection until verifying the patient is ineligible for charity care

Initial billing statements must reflect any applicable charity care discounts, insurance coverage, or health benefits, and all bills must include notice of the charity program with contact information and website URL

If a hospital makes an incorrect charity care determination, it must refund or credit the patient the difference and reimburse reasonable associated costs including legal expenses; if debt was sold to a collection agency, the hospital must notify the agency of corrections

Violations trigger escalating enforcement: first violation requires a corrective action plan published online; second violation allows administrative penalties of at least $250,000 after 90 days' notice; third violation triggers attorney general investigation and potential loss of tax exemptions under Section 311.043(b)