This report is an update to KXAN’s “Medical Debt Lawsuits” investigation. Our team will continue to follow the bills during Texas’ legislative session.
AUSTIN (KXAN) – Legislation that will increase medical billing transparency – by requiring hospitals to provide an itemized receipt to patients before sending their bill to collections – achieved final passage by the Senate on Tuesday.

The Senate’s approval of SB 490 by Sen. Bryan Hughes, (R-Mineola), caps the measure’s passage through both chambers. The bill was sent to Gov. Greg Abbott on Wednesday.
Hughes’ legislation was amended to trim the types of health care providers that would have to send an itemized invoice. In its final form, the bill applies to health care facilities and hospitals but does not apply to doctors or federally qualified health centers.
Hughes said federally qualified health centers already have regulations that make billing information more readily accessible. He described the legislation as a “great bill that is going to help every Texan know what they’re being charged for.”
State Rep. Caroline Harris, R-Round Rock, authored a companion bill in the House.
“Going door to door visiting with voters I’d hear stories about medical bills and debt, often unexplained and over billed charges, that burdened families. From there, I verified gaps in our law that needed to be fixed so patients knew what they were being charged for and the exact accurate cost,” Harris said Tuesday night to KXAN investigators.

Earlier she tweeted that she was honored to lead on the bill and thanked Hughes for accepting the changes.
On May 10, she explained to lawmakers on the House floor that doctors were excluded from the requirement because patients typically have a much closer relationship with their physician than a hospital, which makes it easier to get questions answered and errors fixed. She said federally qualified health centers are excluded because “most of the time the federal government is covering those costs.”
“I’ve got my doctor on speed dial, so if I have concerns about any of the medical billing with him, I know I can contact him directly,” Harris said. “It’s a different story when it comes to hospitals and facilities.”
Hughes’ bill had four coauthors, five sponsors and a bipartisan list of more than 100 co-sponsors.
The legislation received pushback initially from the Texas Hospital Association over the potential cost of providing an itemized bill for every patient.

“It’s remarkable how much opposition there was to bill like this,” Hughes said on the Senate floor Tuesday. “The second session for this bill to go through.”
The bill follows a KXAN investigation into a Central Texas hospital that sued hundreds of patients over unpaid medical bills. Several of those patients told KXAN they received vague bills and were unable to get itemized receipts before being served with a lawsuit.
“That is AWESOME news,” Michelle Ledesma said after learning that the bill is one step closer to becoming law. “I just didn’t tell my story for myself. It was for all of those people like me who were struggling to get the itemized statement but then were sued. It was for those who didn’t know they could fight this. It was for those who were taken advantage of during this process.”