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Signed Into Law
Signed June 20, 2025Effective 2025-09-01
HB216

Regular Session

Relating to itemized billing for health care services and supplies provided by health care providers.

Government Affairs & Regulatory Compliance Analysis

HB216: Government Affairs Overview

Texas HB216 fundamentally alters the "default to digital" billing model for all health care providers effective September 1, 2025. Providers are now prohibited from issuing itemized bills via patient portals unless they first verify the patient has an "active" profile; failure to do so mandates disciplinary action against the provider's professional license.

Rep. Caroline Harris Davila·House Bill·Regular Session

Moderate
Low Cost
Effective:2025-09-01
Enforcing Agencies

Appropriate licensing authorities for health care providers • Health and Human Services Commission • Texas Medical Board

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HB216
Relating to itemized billing for health care services and supplies provided by health care providers.
Moderate Urgency
Unanimous Passage
House Vote130 - 0
YEA
100% in favor130 voting
Senate Vote31 - 0
YEA
100% in favor31 voting
Cost Impact
Low
Effective
2025-09-01
Enforcing Agencies
Appropriate licensing authoritie...Health and Human Services Commis...Texas Medical Board
Primary Author: Rep. Caroline Harris Davila
89th Texas Legislature
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01

Compliance Analysis

Key implementation requirements and action items for compliance with this legislation

Implementation Timeline

  • Effective Date: September 1, 2025
  • Compliance Deadline: September 1, 2025 (Applies to all bills issued on or after this date, regardless of service date).
  • Agency Rulemaking: While the statute is self-executing, the Texas Medical Board and other licensing authorities will likely issue guidance defining "active profile" and "disciplinary matrices" throughout FY 2026.

Immediate Action Plan

  • 1. IT Audit (Immediate): Query your billing software vendor: "Does our system automatically default to paper mail if a patient has not logged into the portal in X days?"
  • 2. Update Workflows: Establish a protocol where any bill sent to a portal without a "read receipt" or login within 7 days triggers an automatic paper backup.
  • 3. Review Insurance: Check your Professional Liability policy for "Administrative Defense" coverage to ensure you are protected against licensing board investigations regarding billing.
  • 4. Clean Data: Initiate a campaign to verify current physical mailing addresses for all patients, as reliance on digital delivery is no longer guaranteed.

Operational Changes Required

Contracts

  • Revenue Cycle Management (RCM) Vendors: You must amend Master Services Agreements (MSAs) immediately. Require vendors to certify that their software can distinguish between "active" and "inactive" portal users.
  • Indemnification Clauses: Update vendor contracts to include indemnification for legal defense costs if a software failure to mail a bill results in a licensing board investigation against your practice.
  • Collection Agencies: Update agreements to prohibit collections activity on accounts where the initial itemized bill delivery cannot be verified under the new HB216 standards.

Hiring/Training

  • Billing Staff: Train staff on the new "30-day trigger." Itemized bills must be sent within 30 days of third-party adjudication.
  • Front Desk: Staff must be trained to provide immediate, on-demand itemized bills for any patient request during the retention period.

Reporting & Record-Keeping

  • Delivery Audit Trails: You must configure your systems to generate a log for every bill issued. The log must prove either:
  • 1. The patient had an "active" portal profile at the exact time of issuance; or
  • 2. The bill was sent via US Mail/email.
  • Returned Mail Logs: To utilize the "Good Faith Defense," you must retain records of returned mail.

Fees & Costs

  • Postage Budget: Anticipate a 10-15% increase in postage costs as "inactive" portal users are forced back to paper billing.
  • Software Upgrades: Potential one-time costs to upgrade practice management software to handle the "active profile" logic gate.

Strategic Ambiguities & Considerations

  • Definition of "Active Profile": The statute does not define what constitutes an "active" profile. Does it mean the account exists, or that the patient has logged in recently? Business Logic: Adopt a conservative standard. If a patient has not logged in within 90 days, treat the profile as inactive and mail the bill to avoid licensure risk.
  • "If Feasible": The law requires the portal check "if feasible." Do not rely on this as a defense. Regulators will interpret "feasible" to mean "technologically possible," not "convenient."

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Information presented is for general knowledge only and is provided without warranty, express or implied. Consult qualified government affairs professionals and legal counsel before making compliance decisions.

02

Legislative Timeline

This bill's path through the Texas Legislature

Filed
Nov 12, 2024
Passed House
May 10, 2025
Passed Senate
May 25, 2025
Signed
Jun 20, 2025
Effective
Sep 1, 2025
TopicsConsumer ProtectionElectronic Information SystemsHealth Care Providers
03

House Authors

Rep. Caroline Harris DavilaRepublican · Primary Author
Joint Authors

Senate Sponsors

Sen. Bryan HughesRepublican · Primary Sponsor
Cosponsors (1)

Bill Text(with markup)

View bill text in multiple formats on Texas Legislature website

Fiscal NoteView Original

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Quick Reference

Frequently Asked Questions

Common questions about HB216

Q

What does Texas HB216 do?

Texas HB216 fundamentally alters the "default to digital" billing model for all health care providers effective September 1, 2025. Providers are now prohibited from issuing itemized bills via patient portals unless they first verify the patient has an "active" profile; failure to do so mandates disciplinary action against the provider's professional license.

Q

Who authored HB216?

HB216 was authored by Texas Representative Caroline Harris Davila during the Regular Session.

Q

When was HB216 signed into law?

HB216 was signed into law by Governor Greg Abbott on June 20, 2025.

Q

Which agencies enforce HB216?

HB216 is enforced by Appropriate licensing authorities for health care providers, Health and Human Services Commission and Texas Medical Board.

Q

How significant are the changes in HB216?

The regulatory priority for HB216 is rated as "moderate". Businesses and organizations should review the legislation to understand potential impacts.

Q

What is the cost impact of HB216?

The cost impact of HB216 is estimated as "low". This may vary based on industry and implementation requirements.

Q

What topics does HB216 address?

HB216 addresses topics including consumer protection, electronic information systems and health care providers.

Q

What are the key dates for HB216?

Key dates for HB216: Effective date is 2025-09-01. Consult with legal counsel regarding applicability.

Q

What are the penalties under HB216?

HB216 establishes the following penalties: administrative penalty of Disciplinary action against license (varies by board) for Failure to provide an itemized bill, or issuing a bill via portal without verifying the patient has an active profile.. Consult with legal counsel for specific applicability to your situation.

Q

Which Texas businesses are affected by HB216?

HB216 primarily affects healthcare providers and medical facilities. These businesses should review the legislation with their legal and compliance teams to understand potential impacts.

Need Strategic Guidance on This Legislation?

JD Key Consulting is an Austin, Texas-based government affairs firm led by James Dickey, former Chairman of the Republican Party of Texas. We specialize in Texas regulatory compliance and legislative strategy for data centers, energy, banking, and manufacturing.

Legislative data provided by LegiScanLast updated: January 11, 2026