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) — On Wednesday, the Texas House voted out an amended version of Senate Bill 490, which pushes for medical transparency of bills patients receive after being treated. 

State Rep. Caroline Harris, R-Round, explaining the itemized medical bill legislation on Wednesday, May 10, 2023.(Courtesy: Melva Gomez, Rep. Harris' Chief of Staff)
State Rep. Caroline Harris, R-Round, explaining the itemized medical bill legislation on Wednesday, May 10, 2023.(Courtesy: Melva Gomez, Rep. Harris’ Chief of Staff)

The legislation — filed by Sen. Bryan Hughes, R-Mineola – now heads back to the Senate for final review, which could be the final step before being sent to the governor.

The legislation requires hospitals requesting payment from a patient to send a written itemized invoice after providing a service and before sending to collections. 

The majority of the House voted in favor of the legislation after adding an amendment that excludes doctors or federally-qualified health care centers from the requirement.

“Our concern was just making sure that, you know, these medical errors can be checked. And again, you know, it’s a lot easier to either go to your doctor’s office, talk to the nurse that helped you or talk to your doctor directly,” State Rep. Caroline Harris, R-Round Rock, said Wednesday at the State Capitol.

Medical debt lawsuits

Harris authored an identical House companion, House Bill 1973, but lawmakers went with the Senate version since it had progressed further in the legislative process. 

“This is a priority for my constituents and for me,” Harris said. 

The legislation follows a KXAN investigation into a Williamson County hospital that filed hundreds of lawsuits against patients for unpaid medical bills. KXAN has shared stories from those impacted who said they tried to get itemized invoices but couldn’t — then got sued for medical debt. 

Harris is familiar with those stories and has heard from Texans fighting lawsuits in court. 

State Rep. Chris Turner, D-Arlington, was the only lawmaker who had questions about the bill, like when healthcare facilities would be required to provide the itemized bill. 

“Before someone is sent to collections, they have to receive that itemized bill. So that can be after insurance has already kicked in — the facility and insurance have figured everything out — and then it’s the final payment that goes to the patient,” Harris explained. “Before they send the patient to collections — to collect on that bill, that’s when they would have to provide the itemized [invoice], so any time up until they send the person to collections.”

The Texas Senate passed the bill in late April without the amendment. 

Opposition and pushback 

The House bill faced pushback from some lawmakers and a Houston health system during the early stages. Concerns were raised about the costs to implement the bill. 

A fiscal note for the bill said there is no significant costs to the state anticipated and — based on analysis — the implementation of the bill could be accomplished by utilizing existing resources.

Last session, a similar Senate bill — also filed by Hughes — failed to advance to this stage.