Relating to direct payment for certain health care provided by a hospital.
Summary
HB 1612 creates a new section in the Texas Health and Safety Code requiring hospitals, upon request, to accept direct payment from certain patients who are not enrolled in a health benefit plan. The request must be made within 60 days after the patient receives a bill or final accounting, and the bill must notify the patient of this option. The measure is aimed at allowing self-pay patients to settle hospital charges directly rather than through an insurer or other health benefit plan.
The bill also limits what hospitals may charge in these direct-payment situations. A hospital may not charge more than 25 percent above the amount generally billed for the service, or more than 50 percent above the lowest contracted rate the hospital has agreed to accept from most other health benefit plans. The bill expressly excludes Medicaid, CHIP, and Medicare rates from the comparison set. It also preserves a patient’s ability to receive charity care if otherwise eligible.
Impact
HB 1612 affects hospital billing practices and patient payment rights by adding a statutory requirement that hospitals accept direct payment from eligible self-pay patients and by capping the amount hospitals may charge in those transactions. It applies to licensed hospitals under Chapter 241, Health and Safety Code, and does not apply to ambulatory surgical centers. The bill interacts with insurance and health plan law by defining health benefit plan broadly, but it carves out public programs such as Medicaid, CHIP, and Medicare from the rate comparison provisions. The act takes effect September 1, 2025.
Sentiment
The bill appears to have broad bipartisan support. It passed the House by a large margin after amendment and then passed the Senate unanimously. The voting history suggests general agreement with the policy goal of giving patients a direct-pay option and limiting hospital charges in those circumstances. No committee transcript was provided, so the available record shows support through votes rather than detailed debate.
Contention
The main policy issue in HB 1612 is how much hospitals may charge self-pay patients and how those charges should be benchmarked. Hospitals may be concerned about the cap on direct-payment amounts and the requirement to accept payment directly at a patient’s request, while patient advocates would likely favor the added transparency and billing protection. Another possible point of discussion is the bill’s exclusion of Medicaid, CHIP, and Medicare from the rate comparison formula, which narrows the pricing reference points and may affect how hospitals calculate allowable charges. The bill also preserves charity care, reducing concern that the new payment option would eliminate existing financial assistance protections.