HB 216: patient portal bills come with a paper backup

Caption

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

Summary

No portal account? The provider mails a paper copy of the itemized bill.

The bill says that when a health care provider sends an itemized bill through an online patient portal, it must check whether the patient actually set up a portal account. If the patient has not, the provider must mail a paper copy of the itemized bill. Health care providers that break the itemized-billing rules face discipline from their licensing board, and the change applies to bills issued on or after September 1, 2025.

Receipt

The receipt

89R-HB216 · 2024-11-12

SOLD BY

Rep. Caroline Harris DavilaRHouse 52

Rep. James FrankRHouse 69

ITEM

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

WHAT IT DOES

No portal account? The provider mails a paper copy of the itemized bill.

The bill says that when a health care provider sends an itemized bill through an online patient portal, it must check whether the patient actually set up a portal account. If the patient has not, the provider must mail a paper copy of the itemized bill. Health care providers that break the itemized-billing rules face discipline from their licensing board, and the change applies to bills issued on or after September 1, 2025.

CHARGES

[ ] NONE FOUND

TOTAL

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version F · source

Sources

Fiscal note · version F · May 26, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

HISTORY

Nov 12, 2024Filed
Feb 27, 2025Read first time
Feb 27, 2025Referred to Public Health
Apr 21, 2025Scheduled for public hearing on . . .
Apr 21, 2025Considered in public hearing
Apr 21, 2025Committee substitute considered in committee
Apr 21, 2025Testimony taken/registration(s) recorded in committee
Apr 21, 2025Left pending in committee
Apr 24, 2025Considered in formal meeting
Apr 24, 2025Committee substitute considered in committee
Apr 24, 2025Reported favorably as substituted
May 2, 2025Comte report filed with Committee Coordinator
May 2, 2025Committee report distributed
May 5, 2025Committee report sent to Calendars
May 7, 2025Considered in Calendars
May 9, 2025Placed on General State Calendar
May 9, 2025Read 2nd time
May 9, 2025Amended 1-Harris Davila
May 9, 2025Passed to engrossment as amended
May 9, 2025Record vote RV#1971
May 10, 2025Read 3rd time
May 10, 2025Passed
May 10, 2025Record vote RV#2050
May 10, 2025Reported engrossed
May 12, 2025Received from the House
May 12, 2025Read first time
May 12, 2025Referred to Health & Human Services
May 20, 2025Scheduled for public hearing on . . .
May 20, 2025Considered in public hearing
May 20, 2025Testimony taken in committee
May 20, 2025Vote taken in committee
May 22, 2025Reported favorably w/o amendments
May 22, 2025Recommended for local & uncontested calendar
May 22, 2025Committee report printed and distributed
May 25, 2025Co-sponsor authorized
May 25, 2025Placed on local & uncontested calendar
May 25, 2025Removed from local & uncontested calendar
May 25, 2025Placed on intent calendar
May 25, 2025Rules suspended-Regular order of business
May 25, 2025Read 2nd time
May 25, 2025Amendment(s) offered FA1 Hughes
May 25, 2025Amended
May 25, 2025Vote recorded in Journal
May 25, 2025Passed to 3rd reading as amended
May 25, 2025Vote recorded in Journal
May 25, 2025Three day rule suspended
May 25, 2025Record vote
May 25, 2025Read 3rd time
May 25, 2025Passed
May 25, 2025Record vote
May 26, 2025Senate passage as amended reported
May 26, 2025Senate Amendments distributed
May 26, 2025Senate Amendments Analysis distributed
May 28, 2025House concurs in Senate amendment(s)
May 28, 2025Record vote RV#3978
May 28, 2025Statement(s) of vote recorded in Journal
May 28, 2025Text of Senate Amendment(s)
May 28, 2025House concurs in Senate amendment(s)-reported
May 29, 2025Reported enrolled
May 30, 2025Signed in the House
May 31, 2025Signed in the Senate
May 31, 2025Sent to the Governor
Jun 20, 2025Signed by the Governor
Jun 20, 2025Effective on 9/1/25

FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 130 yea · 0 nay

Senate · 31 yea · 0 nay

Sources

House: Final passage · May 10, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · May 25, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

No flags

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

Caroline Harris Davila

Donors

Texans for Lawsuit Reform PAC$961K Texas Conservative Majority PAC$739K Court Reform Action for Familes Texas PAC$75K

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Oct 27, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texans for Lawsuit Reform PAC$960,552.08

Texans for Lawsuit Reform PAC

$960,552.08

Cash: $85,000.00
Paid by others: $875,552.08
Total: $960,552.08

advertising $595,238.00mail $237,770.40polling $42,460.35fundraiser $83.33

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Jun 23, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101008087, 101031516, 101035818, 101040655, 101057099, 101067933, 101070037.

Texas Conservative Majority PAC$739,102.00

Texas Conservative Majority PAC

$739,102.00

Cash: $200,000.00
Paid by others: $539,102.00
Total: $739,102.00

canvassing $430,352.00advertising $100,000.00polling $8,750.00

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Sep 8, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101067933, 101070037.

Court Reform Action for Familes Texas PAC$75,000.00

Court Reform Action for Familes Texas PAC

$75,000.00

Cash: $75,000.00
Paid by others: $0.00
Total: $75,000.00

Also funds 0 other sitting lawmakers.

Derived recipient stock · on Oct 6, 2026. State data as of Nov 4, 2026.

Name match, not a verified identity: normalized filed name and state.

Sources

Derived itemized flow · on Oct 6, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101070037.

Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texans for Lawsuit Reform PAC

$960,552.08

Cash: $85,000.00
Paid by others: $875,552.08
Total: $960,552.08

advertising $595,238.00mail $237,770.40polling $42,460.35fundraiser $83.33

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Jun 23, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101008087, 101031516, 101035818, 101040655, 101057099, 101067933, 101070037.

×

Texas Conservative Majority PAC

$739,102.00

Cash: $200,000.00
Paid by others: $539,102.00
Total: $739,102.00

canvassing $430,352.00advertising $100,000.00polling $8,750.00

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Sep 8, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101067933, 101070037.

×

Court Reform Action for Familes Texas PAC

$75,000.00

Cash: $75,000.00
Paid by others: $0.00
Total: $75,000.00

Also funds 0 other sitting lawmakers.

Derived recipient stock · on Oct 6, 2026. State data as of Nov 4, 2026.

Name match, not a verified identity: normalized filed name and state.

Sources

Derived itemized flow · on Oct 6, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101070037.

Votes6

House May 28, 2025

Yea: 130
Nay: 6
Present, not voting: 1
Absent: 3
Excused: 10

Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 3978

Representative Harris Davila moved to concur in the senate amendments to HB 216. The motion to concur in the senate amendments to HB 216 prevailed by (Record 3978): 130 Yeas, 6 Nays, 1 Present, not voting.

Published stock of positions for this vote, except where marked derived.

Yea: 130 (published)
Nay: 6 (published)
Present, not voting: 1 (published)
Absent: 3 (derived from named list)
Excused: 10 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

Senate May 25, 2025

Yea: 31
Nay: 0
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Names

Senate journal

Names were not printed. No individual positions are inferred.

Sources

Senator Hughes moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that HB 216 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 31, Nays 0. The bill was read third time and was passed by the following vote: Yeas 31, Nays 0.

Published stock of positions for this vote, except where marked derived.

Yea: 31 (published)
Nay: 0 (published)
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 25, 2025

Yea: 31
Nay: 0
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Names

Senate journal

Names were not printed. No individual positions are inferred.

Sources

Senator Hughes moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that HB 216 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 31, Nays 0.

Published stock of positions for this vote, except where marked derived.

Yea: 31 (published)
Nay: 0 (published)
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 25, 2025

Yea: Not printed
Nay: Not printed
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Names

Senate journal

Names were not printed. No individual positions are inferred.

Voice vote. No numeric tally or individual yeas are inferred.

Sources

HB 216 as amended was passed to third reading by a viva voce vote.

Published stock of positions for this vote, except where marked derived.

Yea: Not printed
Nay: Not printed
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

House May 10, 2025

Yea: 130
Nay: 0
Present, not voting: 2
Absent: 1
Excused: 17

Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 2050

HB 216 was passed by (Record 2050): 130 Yeas, 0 Nays, 2 Present, not voting.

Published stock of positions for this vote, except where marked derived.

Yea: 130 (published)
Nay: 0 (published)
Present, not voting: 2 (published)
Absent: 1 (derived from named list)
Excused: 17 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

House May 9, 2025

Yea: 133
Nay: 5
Present, not voting: 2
Absent: 4
Excused: 6

Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 1971

CSHB 216, as amended, was passed to engrossment by (Record 1971): 133 Yeas, 5 Nays, 2 Present, not voting.

Published stock of positions for this vote, except where marked derived.

Yea: 133 (published)
Nay: 5 (published)
Present, not voting: 2 (published)
Absent: 4 (derived from named list)
Excused: 6 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

Witnesses24

For: 22
Against: 0
On: 2

Names

For

AARP TX2 registrations
Cicero Action1 registration
Make Texans Healthy Again2 registrations
National Association of Benefits & Insurance Professionals (NABIP) Texas Chapter1 registration
Self3 registrations
Self; Americans for Prosperity1 registration
Self; Paragon Health Institute1 registration
Self; The LIBRE Initiative1 registration
Texans for Affordable Healthcare1 registration
Texas 20362 registrations
Texas Association of Health Plans2 registrations
Texas Public Policy Foundation2 registrations
Texas Women's Healthcare Coalition1 registration
Texas Women’s Healthcare Coalition1 registration
United Ways of Texas1 registration

On

HHSC1 registration
Texas Hospital Association1 registration

Sources

24 parsed registrations across the loaded witness lists.

Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.

House witness list. Source snapshot 2026-10-20, Central time.

Senate witness list. Source snapshot 2026-10-20, Central time.

Fiscal

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version F · source

Sources

Fiscal note · version F · May 26, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

Sources

Texas House · Filed Nov 12, 2024

06/20/2025 E Effective on 9/1/25

Texas Legislature Online · Introduced · House Committee Report · Engrossed · Senate Committee Report · Enrolled

Data snapshot Oct 26, 2026 at 4:20 AM CDT. Grades, charges, quotes and corrections follow the published record.

Companion

SB 669 by Hughes (similar)

SB 1270 by Hughes (identical)

Subjects

Consumer Protection

Electronic Information Systems

Health Care Providers

Text

The text as introduced · 285 words

89R2961 AB-D

By: Harris Davila
H.B. No. 216

A BILL TO BE ENTITLED

AN ACT

relating to itemized billing for health care services and supplies

provided by health care providers.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 185.002, Health and Safety Code, is

amended by amending Subsection (c) and adding Subsection (c-1) to

read as follows:

(c) Except as provided by Subsection (c-1), a [ A ] health

care provider may issue the itemized bill electronically, including

through a patient portal on the provider's Internet website.

(c-1) A health care provider that issues an itemized bill to

a patient electronically through a patient portal under Subsection

(c) shall:

(1) determine whether the patient has created a

patient profile on the portal; and

(2) if the health care provider determines that the

patient has not created a patient portal, mail a copy of the

itemized bill to the patient.

SECTION 2. Section 185.003, Health and Safety Code, is

amended to read as follows:

Sec. 185.003. DISCIPLINARY ACTION BY LICENSING

AUTHORITY. The appropriate licensing authority shall take

disciplinary action against a health care [ the ] provider that

violates this chapter [ for the violation ] as if the provider

violated an applicable licensing law.

SECTION 3. Section 185.002, Health and Safety Code, as

amended by this Act, applies only to an itemized bill issued on or

after the effective date of this Act. An itemized bill issued before

the effective date of this Act is governed by the law in effect on

the date the itemized bill was issued, and the former law is

continued in effect for that purpose.

SECTION 4. This Act takes effect September 1, 2025.

Verdict: No flags

The receipt

SOLD BY

ITEM

WHAT IT DOES

CHARGES

TOTAL

HISTORY

SIGNED FOR BY

Donors

Texans for Lawsuit Reform PAC

Texas Conservative Majority PAC

Court Reform Action for Familes Texas PAC

Texans for Lawsuit Reform PAC

Texas Conservative Majority PAC

Court Reform Action for Familes Texas PAC

House May 28, 2025

Senate May 25, 2025

Senate May 25, 2025

Senate May 25, 2025

House May 10, 2025

House May 9, 2025

For

On

Companion