Monitoring the Session

HB 4670

Manuel’s bill making nursing home dispute rulings binding

Companion SB 2269 became law

Verdict: No flags

No flagsInitial review
Rep. Christian ManuelDHouse 22

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

  1. Filed
  2. Read first time
  3. Referred to Human Services
  4. Scheduled for public hearing on . . .
  5. Considered in public hearing
  6. Testimony taken/registration(s) recorded in committee
  7. Left pending in committee
  8. Considered in public hearing
  9. Committee substitute considered in committee
  10. Reported favorably as substituted
  11. Comte report filed with Committee Coordinator
  12. Committee report distributed
  13. Committee report sent to Calendars
  14. Considered in Calendars
  15. Placed on General State Calendar
  16. Read 2nd time
  17. Postponed 5/12/25 10:00 AM
  18. Companion considered in lieu of CSSB 2269
  19. Laid on the table subject to call
FILED UNDER

No verified beat found.

No flags

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.

Team
Sources

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.

Team
Sources

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.

Team
Sources

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.

Money

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.

Team
Sources

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.

Team
Sources

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.

Team
Sources

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.