This report is an update to KXAN’s “Medical Debt Lawsuits” investigation. Our team will continue to follow the bills during Texas’ legislative session.

Michelle Ledesma won her case after being sued for medical debt but court documents show it was appealed. (KXAN Photo/Arezow Doost)

WILLIAMSON COUNTY, Texas (KXAN) — Michelle Ledesma recalls feeling relieved walking out of a Williamson County courtroom in March. She had been sued by an area hospital for medical debt, but she fought the case, represented herself and won.

“I thought it was over,” Ledesma said. “But it’s not.”

Ledesma explained she recently learned the hospital isn’t letting the case go. It’s appealing in a higher court. 

“It’s created stress. I’m feeling anxiety. It’s making me sick to my stomach,” she added. “I’m thinking to myself, how am I going to fight this even further?”

Ledesma said in 2018 she had to be hospitalized for a severe bacterial infection. She had insurance but was billed more than $2,000 out of pocket. She repeatedly asked the hospital for an itemized invoice but only received vague bills, she said.

“The hospital bill didn’t give any types of descriptions as to how they came about to the total due,” she said, pointing to a stack of documents she’s collected over the year. “I’m willing to pay, but you need to be upfront as to what I’m being charged for.”

It wasn’t until Ledesma was taken to court that she finally received an itemized bill, she said.

‘Not a radical concept’

Stories like Ledesma’s are grabbing the attention of lawmakers at the Texas Capitol who are pushing for more transparent medical billing. 

Senate Bill 490, by Sen. Bryan Hughes, R-Mineola, would require a medical provider to send an itemized bill to a patient — in terms they can understand — before trying to collect any money. 

Senator Bryan Hughes, R-Mineola, after testifying on his itemized medical bill legislation at a Health & Human Services Committee hearing on Wednesday, April 19, 2023. (KXAN Photo/Chris Nelson)

The legislation aims to ensure a health care provider may not pursue debt collection against a patient for a provided health care service or supply unless the provider has complied. 

“Medical bills are confusing enough. And rather than getting a bill that just says ‘balance due,’ this bill says you get an itemized bill. It’s pretty straightforward. Not a radical concept,” Hughes testified Wednesday at the Capitol.

He laid out the bill to members of the Senate Health & Human Services Committee, which didn’t have any questions. Three people spoke in support of the measure. One person was registered in opposition to the bill but was not there to testify during public testimony. The Senate committee voted on the bill late in the week. KXAN investigators are awaiting an update on next steps, as it moves to the full Senate.

During testimony, Hughes pointed out he filed the exact same bill last session. That bill passed the Senate but didn’t advance to become law. 

“Hard to imagine anyone would oppose such a concept,” he added, telling lawmakers there’s a companion bill filed in the House with 107 co-authors. 

While the House bill has had some pushback from a Houston health system and some lawmakers, a House panel approved a substitute this past week, addressing concerns with the bill.

Both pieces of legislation must now make it past their full chambers before some key deadlines in the coming days, as the session begins to wind down.

Fighting for herself and others 

Hughes’ legislation follows a KXAN investigation which revealed hundreds of lawsuits filed on behalf of a Williamson County hospital against patients for unpaid medical bills. Ledesma recently reached out to lawmakers to share her experience with the same hospital, hoping her story can help prevent this issue for other patients in the future.

“It’ll make a difference because it will be more transparent,” she said. “It just feels like the patient is at a disadvantage, and I think this bill will help limit the disadvantage that patients will have to go through.”

Initially, Ledesma’s case resulted in a judgment in her favor. It had few details but did say the hospital “should take nothing” by its suit. According to court documents, the hospital is appealing because it was “denied a judgment in full.” The retired state worker said she now worries about having to dip into her savings to fight the appeal.

“I’m not just fighting for myself. I’m fighting for those other people that I saw in court as well, trying to figure out what was going on,” she added.