HB 4670
Manuel’s bill making nursing home dispute rulings binding
Companion SB 2269 became law
Verdict: No flags
Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade
Caption
relating to dispute resolution for and enforcement actions against certain long-term care facilities.
Caption from analyzed text · version I.
Summary
No state fine for an act federal regulators already penalized.
The bill makes the outside referee's decision in a nursing home's informal dispute with the state health commission binding, so the commission cannot overturn it. It bars the commission from fining a nursing facility under state law for the same act already penalized by the federal Medicare and Medicaid agency, or still under federal appeal on a similar rule. It also forbids the commission from retaliating against a facility that appeals or challenges a commission decision in good faith, starting with violations on or after September 1, 2025.
Receipt
The receipt
89R-HB4670 · 2025-03-12
SOLD BY
+ 1 more author
ITEM
relating to dispute resolution for and enforcement actions against certain long-term care facilities.
WHAT IT DOES
No state fine for an act federal regulators already penalized.
The bill makes the outside referee's decision in a nursing home's informal dispute with the state health commission binding, so the commission cannot overturn it. It bars the commission from fining a nursing facility under state law for the same act already penalized by the federal Medicare and Medicaid agency, or still under federal appeal on a similar rule. It also forbids the commission from retaliating against a facility that appeals or challenges a commission decision in good faith, starting with violations on or after September 1, 2025.
CHARGES
[ ] NONE FOUND
TOTAL
No significant fiscal implication to the State is anticipated.
LBB estimate · fiscal note version H · source
Sources
Fiscal note · version H · April 23, 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
- Filed
- Read first time
- Referred to Human Services
- Scheduled for public hearing on . . .
- Considered in public hearing
- Testimony taken/registration(s) recorded in committee
- Left pending in committee
- Considered in public hearing
- Committee substitute considered in committee
- Reported favorably as substituted
- Comte report filed with Committee Coordinator
- Committee report distributed
- Committee report sent to Calendars
- Considered in Calendars
- Placed on General State Calendar
- Read 2nd time
- Postponed 5/12/25 10:00 AM
- Companion considered in lieu of CSSB 2269
- Laid on the table subject to call
FILED UNDER
No verified beat found.
THANK YOU FOR CHECKING THE RECEIPT
CAMPAIGN PAID FOR BY
CAMPAIGN PAID FOR BY
Donors
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 · Jul 23, 2024 to Jun 30, 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.
ENPAC Texas$5,000.00
ENPAC Texas
$5,000.00
- Cash
- $5,000.00
- Paid by others
- $0.00
- Total
- $5,000.00
Also funds 27 other sitting lawmakers.
Derived recipient stock · Sep 26, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.
Name match, not a verified identity: normalized filed name and state.
TeamSources
Derived itemized flow · on Nov 10, 2025. 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: 101033978.
Texas Trial Lawyers Association PAC$5,000.00
Texas Trial Lawyers Association PAC
$5,000.00
- Cash
- $5,000.00
- Paid by others
- $0.00
- Total
- $5,000.00
Also funds 137 other sitting lawmakers.
Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.
TEC account match.
TeamSources
Derived itemized flow · Jul 7, 2025 to Oct 1, 2025. 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: 101033978.
Texas Sands PAC$4,000.00
Texas Sands PAC
$4,000.00
- Cash
- $4,000.00
- Paid by others
- $0.00
- Total
- $4,000.00
Also funds 121 other sitting lawmakers.
Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.
TEC account match.
TeamSources
Derived itemized flow · on May 18, 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: 101061945.
Missing data does not establish zero giving. Display amounts are rounded.
ENPAC Texas
$5,000.00
- Cash
- $5,000.00
- Paid by others
- $0.00
- Total
- $5,000.00
Also funds 27 other sitting lawmakers.
Derived recipient stock · Sep 26, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.
Name match, not a verified identity: normalized filed name and state.
TeamSources
Derived itemized flow · on Nov 10, 2025. 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: 101033978.
Texas Trial Lawyers Association PAC
$5,000.00
- Cash
- $5,000.00
- Paid by others
- $0.00
- Total
- $5,000.00
Also funds 137 other sitting lawmakers.
Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.
TEC account match.
TeamSources
Derived itemized flow · Jul 7, 2025 to Oct 1, 2025. 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: 101033978.
Texas Sands PAC
$4,000.00
- Cash
- $4,000.00
- Paid by others
- $0.00
- Total
- $4,000.00
Also funds 121 other sitting lawmakers.
Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.
TEC account match.
TeamSources
Derived itemized flow · on May 18, 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: 101061945.
Votes
No floor vote loaded for this bill.
Witnesses11
- For
- 9
- Against
- 0
- On
- 2
Names
For
- Morningside Ministries1 registration
- Self1 registration
- Self; HMG Healthcare, LLC1 registration
- Self; TORCH2 registrations
- Self; Touchstone Communities Inc1 registration
- Texas Assisted Living Association1 registration
- Texas Health Care Association1 registration
- The Independent Coalition of Nursing Home Providers1 registration
On
- Health and Human Services Commission2 registrations
Sources
11 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.
Fiscal
No significant fiscal implication to the State is anticipated.
LBB estimate · fiscal note version H · source
Sources
Fiscal note · version H · April 23, 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 Mar 12, 2025
05/12/2025 H Laid on the table subject to call
Texas Legislature Online · Introduced · House Committee Report
Data snapshot Oct 26, 2026 at 4:20 AM CDT. Grades, charges, quotes and corrections follow the published record.
House committee · Human Services · Committee vote 10 aye, 0 nay, 1 absent · Out of committee
Companion
SB 2269 by Perry (very similar)
Subjects
Nursing Homes
LONG-TERM CARE
MEDIATION, DISPUTE RESOLUTION, & ARBITRATION
HEALTH & HUMAN SERVICES COMMISSION
Text
The text as introduced · 478 words
By: Manuel H.B. No. 4670 A BILL TO BE ENTITLED AN ACT relating to dispute resolution for and enforcement actions against certain long-term care facilities. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 526.0202, Government Code, as effective April 1, 2025, is amended by adding Subsection (b-1) to read as follows: (b-1) A decision under the informal dispute resolution process by the contracting person adjudicating a dispute between the commission and a facility described by Subsection (b) is binding on the parties and cannot be overturned by the commission. SECTION 2. Section 242.002, Health and Safety Code, is amended by adding Subdivision (13) to read as follows: (13) "Retaliate" means an adverse action by the commission in response to a good faith action by a nursing facility responding to a commission decision negatively affecting the nursing facility. SECTION 3. Section 242.070, Health and Safety Code, is amended to read as follows: Sec. 242.070. APPLICATION OF OTHER LAW. (a) The commission [ department ] may not assess more than one monetary penalty under this chapter and Chapter 32, Human Resources Code, for a violation arising out of the same act or failure to act, except as provided by Section 242.0665(c). The commission [ department ] may assess the greater of a monetary penalty under this chapter or a monetary penalty under Chapter 32, Human Resources Code, for the same act or failure to act. (b) The commission may not impose an administrative penalty under this chapter and Chapter 32, Human Resources Code, against a nursing facility for a violation arising out of the same act or failure to act that is the subject of: (1) a penalty imposed by the Centers for Medicare and Medicaid Services under 42 C.F.R. Section 488.408 against the facility; or (2) a penalty the facility appeals under 42 C.F.R. Part 498 before the facility exhausts all rights of appeal if: (A) the federal requirement is the same or substantially similar to a requirement in this chapter or Chapter 32, Human Resources Code; and (B) Subdivision (1) does not apply. SECTION 4. Subchapter C, Chapter 242, Health and Safety Code, is amended by adding Section 242.075 to read as follows: Sec. 242.075. PROHIBITED RETALIATION. The commission may not retaliate against a nursing facility in response to the facility in good faith appealing a commission decision or filing another action to counter a commission action against the facility. SECTION 5. The changes in law made by this Act apply only to a violation that occurs on or after the effective date of this Act. A violation that occurs before the effective date of this Act is governed by the law as it existed immediately before the effective date of this Act, and that law is continued in effect for that purpose. SECTION 6. This Act takes effect September 1, 2025.

