Texas healthcare is on the brink of significant transformation. As the legislature debates several key bills that could reshape healthcare delivery across the state, medical practices and hospitals must prepare for substantial operational and financial changes.
These proposed changes touch everything from maternal care coverage to reproductive health services, with each bill carrying distinct implications for healthcare providers. At Nichols Weitzner Thomas LLP, we’ve been monitoring these developments closely to help our clients navigate the evolving regulatory landscape.
Texas Healthcare Bills to Watch Out For
1. Extended Medicaid Coverage for New Mothers (HB 757)
What the bill proposes: Currently, Medicaid coverage for new mothers in Texas ends just 60 days after childbirth. HB 757 amends the Human Resources Code to extend Medicaid coverage for women from the current period to a minimum of 24 months following the last month of pregnancy. This represents a fundamental shift in how maternal care is financed and delivered in Texas.
Impact on hospitals and medical practices:
- Clinical documentation: New requirements for tracking extended postpartum care will need integration into your electronic health records and quality reporting systems to ensure compliance.
- Reduced readmissions: With two full years of postpartum coverage, hospitals may see significantly fewer emergency readmissions for complications that could be managed through routine care.
- Discharge planning: Case management departments will need to develop longer-term care coordination protocols spanning the full 24-month coverage period.
- Revenue cycle impacts: Financial departments should prepare for more predictable reimbursement patterns for postpartum services and reduced uncompensated care.
Legal considerations: The bill includes a contingency provision allowing state agencies to delay implementation until necessary federal waivers or authorizations are obtained. The Act takes effect on September 1, 2025, giving providers time to prepare for implementation.
2. Streamlined Medicaid and CHIP Enrollment (SB 238)
What the bill proposes: SB 238 creates an innovative “express lane” enrollment pathway that would allow automatic Medicaid/CHIP eligibility determinations based on participation in the Supplemental Nutrition Assistance Program (SNAP).
Impact on hospitals and medical practices:
- Patient volume changes: Practices may experience increased patient volume as more Texans gain insurance coverage through streamlined enrollment.
- Financial counseling: Patient financial services may need to adjust processes for determining eligibility and explaining benefits.
- Charity care programs: Hospitals may need to reassess financial assistance programs as more patients become eligible for Medicaid coverage.
- Administrative processes: Admissions and registration departments will need updated protocols for verifying eligibility through these new pathways.
Legal considerations: Providers should ensure compliance with documentation requirements for this new eligibility pathway, particularly during the implementation phase when systems may still be adjusting.
3. Medicaid Coverage for Doula Services (HB 2573)
What the bill proposes: Another Texas healthcare law you should keep an eye on is HB 2573. It expands the maternal care team by requiring Medicaid to cover doula services from pregnancy confirmation through 12 months postpartum.
Impact on hospitals and medical practices:
- Care coordination: OB/GYN practices will need protocols for working collaboratively with doulas, including communication channels and documentation standards.
- Referral networks: Practices may want to develop relationships with qualified doulas to facilitate patient access to these newly covered services.
- Labor and delivery policies: Hospitals must develop or update policies regarding doula presence during labor, delivery, and postpartum care.
- Facility considerations: Some physical spaces may need adaptation to accommodate doulas while maintaining appropriate clinical workflows.
Legal considerations: Clear delineation of roles and responsibilities between clinical staff and doulas will be important to minimize liability concerns and ensure appropriate scope of practice.
4. Changes to Reproductive Health Coverage (HB 1098)
What the bill proposes: HB 1098 would significantly expand coverage for reproductive health services including contraception, abortion, and sterilization under both Medicaid and certain health plans, explicitly prohibiting administrative barriers like prior authorization.
Impact on hospitals and medical practices:
- Service offering adjustments: Depending on the final language, practices may need to modify reproductive health services in accordance with coverage changes.
- Informed consent processes: Updated consent forms and patient education materials may be required to reflect changing coverage.
- Pharmacy protocols: Hospital pharmacies may need to adjust formularies and stocking practices for contraceptive methods.
- Documentation systems: Electronic health records may require updates to capture compliant documentation for reproductive health services.
Legal considerations: This area presents particularly significant compliance challenges, requiring careful attention to both federal and state requirements. Maintaining appropriate documentation will be essential for defending against potential regulatory scrutiny.
How a Healthcare Law Firm Can Help You Prepare for the Impact
These regulatory changes come at a time when many healthcare providers are already managing significant operational challenges. The potential implementation of these bills would add another layer of complexity to your daily operations.
At Nichols Weitzner Thomas LLP, we see our role as helping to shoulder that burden. Our healthcare attorneys work alongside medical practices and hospitals to interpret these complex regulations in practical terms. We recognize that every healthcare organization has unique needs and constraints, which is why we focus on tailored guidance rather than one-size-fits-all approaches.
Schedule a conversation with us about Texas healthcare law today.
This article is provided for informational purposes only and does not constitute legal advice. The analysis of pending legislation is based on current proposals, which may change before final passage. Healthcare providers should consult with qualified legal counsel regarding their specific circumstances.
