Relating to information regarding perinatal palliative care; creating an administrative penalty.
ModeratePlan for compliance
Low Cost
Effective:2025-09-01
Enforcing Agencies
Health and Human Services Commission (HHSC) • State Licensing Agencies (e.g., Texas Medical Board, Texas Board of Nursing)
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. Providers must have the specific HHSC forms loaded into their physical or digital intake systems by this date.
Agency Rulemaking: The Health and Human Services Commission (HHSC) is statutorily required to develop the informational materials, the provider list, and the certification form *prior* to the effective date. Expect these materials to be published in the *Texas Register* between May and August 2025, creating a narrow window for final implementation.
Immediate Action Plan
Assign Monitoring: Designate a compliance officer to monitor the HHSC website weekly starting Q2 2025 for the release of the mandatory forms.
Update EMR Logic: Configure medical record systems to flag "High Risk" prenatal diagnoses and trigger a hard-stop reminder for the provider to present the certification form.
Revise Policies: Update internal policy manuals to classify failure to obtain this signature as a disciplinary compliance breach, mirroring the state's penalty structure.
Prepare Paper Backups: Have physical copies of the HHSC materials and forms ready by August 2025 in case of EMR downtime or software integration delays.
Operational Changes Required
Contracts
EMR/EHR Vendors: Initiate change orders with Electronic Medical Record vendors immediately. Systems must be updated to host the mandatory HHSC "Perinatal Palliative Care Certification Form" and allow for e-signatures.
Telehealth Platforms: If your practice delivers diagnostic results remotely, your telehealth platform contract must support verified, secure document signing during the consultation to satisfy the "receipt of materials" requirement.
Hiring/Training
Clinical Training: Physicians, sonographers, and genetic counselors require training on the specific statutory definition of "life-threatening or life-limiting illness" to know when the disclosure obligation is triggered.
Workflow Training: Staff must be trained to check the patient record for a pre-existing signed form to avoid traumatizing patients with redundant disclosures for the same pregnancy.
Reporting & Record-Keeping
Mandatory Form: You must use the state-prescribed "Perinatal Palliative Care Certification Form." Homegrown forms are non-compliant.
Audit Trail: The signed form must be permanently filed in the patient's medical record. In the event of a licensing board complaint, this document is your primary defense against administrative penalties.
Fees & Costs
Penalties: $0 for the first violation (written warning); $1,000 for each subsequent failure to provide materials or obtain the signature.
Operational Costs: Minimal direct costs, primarily absorbed in administrative time and EMR system configuration fees.
Strategic Ambiguities & Considerations
Definition of "Life-Limiting": The statute uses broad terminology. It is currently unclear if this applies strictly to fatal diagnoses (e.g., anencephaly) or extends to severe but survivable conditions. Until HHSC rulemaking provides a specific clinical list or narrower definition, providers should adopt a conservative approach and utilize the form for any severe diagnosis to ensure compliance.
Telehealth Logistics: The law requires the provider to "obtain" the signed form. It does not explicitly detail the mechanism for remote diagnoses. Rulemaking will likely clarify if a digital audit trail (e.g., DocuSign log) satisfies the requirement for a "signature."
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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.
Perinatal palliative care is the means of providing comprehensive, supportive care to reduce the suffering of a pregnant woman, her preborn child, and her family, from diagnosis of the preborn child's life-threatening disability until one year after birth. Promptly providing information and care during this time is crucial because many pregnant women are unaware of the services available to ease the pain and suffering they may endure. This information and care may be about care for the mother and child; health care and other services available for the mother, child, and family; and information about medical assistance benefits that may be available.
S.B. 1233 aims to make these resources more easily accessible to expectant mothers.
As proposed, S.B. 1233 amends current law relating to information regarding perinatal palliative care and creates an administrative penalty.
RULEMAKING AUTHORITY
This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.
SECTION BY SECTION ANALYSIS
SECTION 1. Authorizes this Act to be cited as the Perinatal Palliative Care Act.
SECTION 2. Provides that the legislature finds that:
(1) palliative care is a critical form of care provided to alleviate the pain and suffering of individuals with severe life-threatening disabilities or diseases;
(2) in approximately two percent of pregnancies, the preborn child is diagnosed with a life-threatening medical condition that will likely result in the child's death before or shortly after birth; and
(3) since the lives of preborn children are no longer prematurely taken by abortion in this state, many of the children described by Subdivision (2) are born alive.
SECTION 3. Amends Chapter 161, Health and Safety Code, by adding Subchapter Z, as follows:
SUBCHAPTER Z. PERINATAL PALLIATIVE CARE
Sec. 161.751. PURPOSE OF SUBCHAPTER. Sets forth the purpose of this subchapter.
Sec. 161.752. DEFINITIONS. Defines "health care provider" and "perinatal palliative care."
Sec. 161.753. PERINATAL PALLIATIVE CARE INFORMATIONAL MATERIALS. (a) Requires the Health and Human Services Commission (HHSC) to develop perinatal palliative care informational materials and post the materials on HHSC's Internet website. Requires that the materials include a description of the health care and other services available through perinatal palliative care and information about medical assistance benefits that may be available for prenatal care, childbirth, and perinatal palliative care.
(b) Requires HHSC to develop, regularly update, and publish a geographically indexed list of all perinatal palliative care providers and programs in this state. Authorizes HHSC to include perinatal palliative care providers and programs in other states that provide care to residents of this state but prohibits HHSC from including an abortion provider, as defined by Section 171.002 (Definitions), or an affiliate, as defined by Section 2273.001 (Definitions), Government Code, of an abortion provider.
(c) Requires HHSC to post on HHSC's Internet website the list of perinatal palliative care providers and programs, including contact information, and note the providers and programs that provide services free of charge.
Sec. 161.754. PERINATAL PALLIATIVE CARE CERTIFICATION FORM. Requires HHSC to develop a form on which a pregnant woman certifies she received the perinatal palliative care informational materials and list of the perinatal palliative care providers and programs described by Section 161.753.
Sec. 161.755. HEALTH CARE PROVIDER DUTIES ON DIAGNOSIS OF PREBORN CHILD'S LIFE-THREATENING DISABILITY. Requires a health care provider who diagnoses a pregnant woman's preborn child as having a life-threatening disability to, at the time of the diagnosis:
(1) provide the pregnant woman with a written copy of the perinatal palliative care informational materials and list of the perinatal palliative care providers and programs described by Section 161.753 and the perinatal palliative care certification form described by Section 161.754; and
(2) obtain from the pregnant woman the signed perinatal palliative care certification form and place the form in the pregnant woman's medical records.
Sec. 161.756. EXCEPTION. Provides that a health care provider is not required to provide the perinatal palliative care informational materials or perinatal palliative care certification form under this subchapter if the health care provider verifies the pregnant woman's medical record contains a signed perinatal palliative care certification form for that pregnancy as required under Section 161.755(2).
Sec. 161.757. DISCIPLINARY ACTION; ADMINISTRATIVE PENALTY. Provides that a health care provider who violates Section 161.755 is subject to disciplinary action by the state licensing agency that regulates the provider. Requires the licensing agency, on determining the provider committed a violation, for an initial violation, issue a written warning to the provider and for each subsequent violation, impose on the provider an administrative penalty in the amount of $1,000.
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
SB1233 by Hancock (Relating to information regarding perinatal palliative care; creating an administrative penalty.), As Introduced
The fiscal implications of the bill cannot be fully determined as the Health and Human Services Commission and Comptroller of Public Accounts do not have the information necessary to make appropriate assumptions to determine the potential fiscal impact.
Local Government Impact
The fiscal implications of the bill cannot be determined at this time.
Source Agencies: b > td >
304 Comptroller of Public Accounts, 529 Health and Human Services Commission
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SB1233 mandates a strict new compliance workflow for all Texas prenatal care providers, requiring specific disclosures and a signed patient certification form immediately upon diagnosing a life-threatening fetal condition. Effective September 1, 2025, failure to obtain this signature triggers administrative penalties of up to $1,000 per instance and disciplinary action against the provider's professional license. Implementation Timeline Effective Date: September 1, 2025 Compliance Deadline: September 1, 2025.
Q
Who authored SB1233?
SB1233 was authored by Texas Senator Kelly Hancock during the Regular Session.
Q
When was SB1233 signed into law?
SB1233 was signed into law by Governor Greg Abbott on June 20, 2025.
Q
Which agencies enforce SB1233?
SB1233 is enforced by Health and Human Services Commission (HHSC) and State Licensing Agencies (e.g., Texas Medical Board, Texas Board of Nursing).
Q
How urgent is compliance with SB1233?
The compliance urgency for SB1233 is rated as "moderate". Businesses and organizations should review the requirements and timeline to ensure timely compliance.
Q
What is the cost impact of SB1233?
The cost impact of SB1233 is estimated as "low". This may vary based on industry and implementation requirements.
Q
What topics does SB1233 address?
SB1233 addresses topics including abortion, health care providers, perinatal palliative care act, pregnancy & childbirth and health & human services commission.
Legislative data provided by LegiScanLast updated: November 25, 2025
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