TX HB4408

Requires health care entities with at least $10 million in total assets and annual revenue to report ownership and control information annually to the Secretary of State, including legal names, business addresses, taxpayer identification numbers, organizational charts, and comprehensive financial reports

Applies to material change transactions such as mergers, acquisitions, changes of control, formation of joint ventures or management services organizations, and sales or transfers involving health care providers, facilities, hospitals, insurers, and pharmacy benefit managers

Exempts independent provider organizations with three or fewer physicians that are not under ownership or control of another entity, as well as clinical trial collaborations, graduate medical education programs, and hiring of single physicians

Establishes civil penalties of up to $50,000 per violation for small independent practices (10 or fewer physicians, under $10 million revenue) and up to $500,000 per violation for larger health care entities that fail to report or submit false information

Requires the Secretary of State to publish annual public reports by July 1 each year analyzing health care entity ownership, consolidation trends, and changes in control, with the first report due July 1, 2026