Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
SB945 by Kolkhorst (relating to the disclosure of certain health care cost information by certain health care facilities; authorizing an administrative penalty.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for SB945, Committee Report 1st House, Substituted : an impact of $0 through the biennium ending August 31, 2025.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
General Revenue-Related Funds, Five- Year Impact:
Fiscal Year
Probable Net Positive/(Negative) Impact to General Revenue Related Funds
2024
$0
2025
$0
2026
($2,736,040)
2027
($1,903,809)
2028
($1,905,171)
All Funds, Five-Year Impact:
Fiscal Year
Probable Savings/(Cost) from General Revenue Fund 1
Probable Savings/(Cost) from GR Match For Medicaid 758
Probable Savings/(Cost) from Federal Funds 555
Change in Number of State Employees from FY 2023
2024
$0
$0
$0
0.0
2025
$0
$0
$0
0.0
2026
($2,670,878)
($65,162)
($65,162)
15.3
2027
($1,903,809)
$0
$0
15.3
2028
($1,905,171)
$0
$0
15.3
Fiscal Analysis
The bill would expand the definition of facility to include freestanding emergency medical care facilities, urgent care or retail clinics, outpatient clinics, birthing centers, ambulatory surgical centers, or other facilities licensed to provide health care services. The bill would expand the types of health care facilities subject to administrative penalties under Section 327.008(a) of the Health and Safety Code. The bill would take effect immediately upon receiving a two-thirds majority vote in each house. Otherwise, the bill would take effect September 1, 2023.
Methodology
The bill would permit facilities to come into compliance with disclosure of billing information not later than August 2027. This analysis assumes HHSC would not require full-time-equivalents (FTEs) and one-time technology modifications, specified further below, until the 2026-27 biennium. Actual cost and FTEs needed to implement the bill may vary based on the number of facilities that come into compliance with the bill sooner than the date required by the bill.
According to the Health and Human Services Commission (HHSC), additional funding and FTEs would be needed to monitor compliance of the additional facilities added by the bill.
This analysis assumes HHSC would need additional FTEs as follows to implement the bill: 2.0 Program Specialist V for enforcement duties, including recommendation of administrative penalties; 3.0 Program Specialist VI to update rules for the additional types of facilities impacted by the bill; 9.0 Compliance Analyst IV to monitor facility compliance with facility price disclosure; 1.0 Protective Services Intake Specialist V to review additional complaints and open records requests; and 0.3 Program Specialist V for indirect agency functions. Analysis assumes a total of 15.3 FTEs are needed in each fiscal year, beginning in fiscal year 2026, to implement the provisions of the bill. Personnel related costs, including salaries, travel, and overhead, are estimated to total $1,965,260 in All Funds beginning in fiscal year 2026.
The revenue impact from potential increases to administrative penalties under Section 327.008(a) cannot be estimated.
Technology
The total technology cost is estimated to be $885,111 in All Funds beginning in fiscal year 2026. Costs are primarily related to one-time modifications to the Texas Unified Licensure Information Portal to accommodate the changes to applications required by the bill, and personnel-related costs.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies:
304 Comptroller of Public Accounts, 529 Health and Human Services Commission