TX HB5023

Requires commissioners courts to contract with an independent auditor at least once every five years for a comprehensive performance audit of hospital districts in populous counties

Audits must evaluate the district's management, accounting practices, financial controls, recordkeeping, legal compliance, and vendor contract performance

Audits must determine whether district management adheres to best practices and national standards for hospital and hospital system administration

Auditors must produce a written report identifying deficiencies and providing recommendations, which must be provided to both the district and commissioners court

Districts with public websites must post audit reports in a conspicuous location, and commissioners courts must hold a public hearing on each report

Effective date: September 1, 2025