A new law in Texas, House Bill 1314, introduces significant changes to billing requirements for healthcare facilities.
Effective Sept. 1, 2025, this legislation altered how hospitals and health systems provide cost estimates for nonemergency medical services. Understanding these new rules is essential for maintaining compliance and managing revenue cycle operations.
Key Provisions of Texas HB 1314
Texas HB 1314 amends the state's Health and Safety Code to give consumers greater price transparency. The law centers on the right of consumers to receive a good faith estimate for nonemergency elective medical services.
Upon request, a healthcare facility must provide a consumer with a written estimate of the total expected billed charges for any elective inpatient admission or nonemergency outpatient service. The law defines an "estimate" as a written statement outlining these expected charges.
Facilities must provide the estimate via email no later than five business days after receiving the consumer's request. This is a change from the previous 10-business-day timeframe.
When providing an estimate, facilities must advise consumers of several key points:
- The request for an estimate may delay the scheduling of the service
- Actual charges may vary from the estimate based on the patient's medical condition and other factors
- The final billed amount may differ from what the consumer or their insurance plan will pay
- The consumer may be personally liable for payment depending on their health plan's coverage
- The consumer should contact their health plan for accurate information on benefits, deductibles and coinsurance
RELATED: Financial Protection for Consumers
The bill adds a significant protection for consumers. The estimate must include information on how a consumer can dispute final billed charges that exceed the estimated amount by $400 or more, as specified by federal regulations.
Compliance Requirements for Facilities
To comply with HB 1314, hospitals and health systems must update their processes for generating and delivering patient estimates. This includes ensuring that all required information is included and estimates are provided within the five-business-day window.
Facilities must have a system in place to:
- Receive and track consumer requests for estimates
- Generate accurate, itemized estimates of total billed charges
- Email the estimate to the consumer promptly
- Include all mandated disclosures and information about the dispute resolution process
Penalties for Non-Compliance
The consequences for failing to comply with HB 1314 are substantial. A facility that violates the law:
- Is prohibited from taking any third-party collection action against the consumer
- May not report the consumer to a credit bureau
- Cannot pursue legal action against the consumer
- Is subject to enforcement action by its appropriate licensing agency
Impact on Revenue Cycle Management
HB 1314 directly impacts revenue cycle management (RCM) by placing a greater emphasis on price transparency and billing accuracy. Hospitals and health systems must ensure their pricing strategies are clear and that they can produce reliable estimates quickly.
Technology will play a critical role in meeting these requirements. Automated RCM solutions can help facilities generate precise estimates, track patient requests and ensure all communications meet legal standards. Integrating these tools can help prevent compliance issues and streamline front-end revenue cycle processes.
Prepare Your Hospital with FinThrive
Navigating regulations like Texas HB 1314 requires robust technology. FinThrive’s Payment Estimator meets and exceeds HB 1314 requirements for both insured and self-pay patients, providing compliance confidence.
It also helps to automate the creation of accurate, patient-friendly estimates with over 90% price estimate accuracy.
This supports federal and state mandates, including the No Surprises Act. Patients benefit from easy-to-read worksheets and 24/7 self-service estimate generation via provider websites, fostering patient empowerment. This clarity also accelerates cash collection, reduces collection costs and improves patient satisfaction.
Interested in learning more? Reach out to our team.
Frequently Asked Questions
What is Texas HB 1314?
Texas HB 1314 is a state law, effective September 1, 2025, that requires healthcare facilities to provide consumers with a written estimate of billed charges for nonemergency elective medical services upon request.
What is the deadline for providing an estimate under HB 1314?
Facilities must email the estimate to the consumer within five business days of receiving the request.
What happens if a facility violates HB 1314?
A non-compliant facility is barred from pursuing collections or legal action against the consumer and faces potential enforcement from its licensing agency.
How does this law affect patient billing?
The law provides consumers with a way to dispute final bills that exceed the provided estimate by $400 or more, increasing the need for billing accuracy.
