Monitoring the Session

HB 4743

one license for a hospital and its mobile stroke unit

Became law, effective Sep 1, 2025

Verdict: No flags

No flagsInitial review
Rep. Greg BonnenRHouse 24

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 the issuance of a single license for a hospital and a mobile stroke unit of the hospital.

Caption from analyzed text · version I.

Summary

If the unit is accredited by a Medicare-approved group.

The bill lets the state health department issue one license that covers both a hospital and that hospital's mobile stroke unit, as long as the unit is accredited by an accreditation group approved by the federal Medicare and Medicaid agency. It touches hospitals that run mobile stroke units and the state agency that licenses them, and it exempts these combined licenses from an existing Subsection (g) of the hospital licensing law. On the ground, a hospital could run its stroke ambulance under its main license instead of getting separate licensing, with state rules to follow and a September 1, 2025 start date.

Labels

Labels: ACROSS THE AISLE. Joint authors: 1 Republican, 1 Democrat. Party as the Legislative Reference Library lists it for the 89th Legislature.

Receipt

The receipt

89R-HB4743 · 2025-03-13

SOLD BY

ITEM

relating to the issuance of a single license for a hospital and a mobile stroke unit of the hospital.

WHAT IT DOES

If the unit is accredited by a Medicare-approved group.

The bill lets the state health department issue one license that covers both a hospital and that hospital's mobile stroke unit, as long as the unit is accredited by an accreditation group approved by the federal Medicare and Medicaid agency. It touches hospitals that run mobile stroke units and the state agency that licenses them, and it exempts these combined licenses from an existing Subsection (g) of the hospital licensing law. On the ground, a hospital could run its stroke ambulance under its main license instead of getting separate licensing, with state rules to follow and a September 1, 2025 start date.

CHARGES

[ ] NONE FOUND

TOTAL

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · May 19, 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 Public Health
  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 formal meeting
  9. Reported favorably w/o amendment(s)
  10. Comte report filed with Committee Coordinator
  11. Committee report distributed
  12. Committee report sent to Calendars
  13. Considered in Calendars
  14. Placed on General State Calendar
  15. Read 2nd time
  16. Passed to engrossment
  17. Record vote RV#1712
  18. Statement(s) of vote recorded in Journal
  19. Read 3rd time
  20. Passed
  21. Record vote RV#1819
  22. Reported engrossed
  23. Received from the House
  24. Read first time
  25. Referred to Health & Human Services
  26. Scheduled for public hearing on . . .
  27. Considered in public hearing
  28. Left pending in committee
  29. Considered in public hearing
  30. Vote taken in committee
  31. Reported favorably w/o amendments
  32. Recommended for local & uncontested calendar
  33. Committee report printed and distributed
  34. Co-sponsor authorized
  35. Placed on intent calendar
  36. Rules suspended-Regular order of business
  37. Read 2nd time & passed to 3rd reading
  38. Vote recorded in Journal
  39. Three day rule suspended
  40. Record vote
  41. Read 3rd time
  42. Passed
  43. Record vote
  44. Senate passage reported
  45. Reported enrolled
  46. Signed in the House
  47. Signed in the Senate
  48. Sent to the Governor
  49. Signed by the Governor
  50. Effective on 9/1/25
FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 146 yea · 0 nay

Senate · 31 yea · 0 nay

Sources

House: Final passage · May 8, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · May 26, 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

CAMPAIGN PAID FOR BY

Donors

Donors report through Friends of Dr. Greg Bonnen.

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 1, 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.

Money

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

Votes5

Senate May 26, 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 Campbell moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that HB 4743 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 26, 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 Campbell moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that HB 4743 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 26, 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

The bill was read second time and 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 8, 2025

Yea
146
Nay
0
Present, not voting
2
Absent
0
Excused
2
Names

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

House journal

Sources

Record 1819

HB 4743 was passed by (Record 1819): 146 Yeas, 0 Nays, 2 Present, not voting.

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

  • Yea: 146 (published)
  • Nay: 0 (published)
  • Present, not voting: 2 (published)
  • Absent: 0 (derived from named list)
  • Excused: 2 (derived from named list)

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

House May 7, 2025

Yea
141
Nay
0
Present, not voting
1
Absent
4
Excused
4
Names

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

House journal

Sources

Record 1712

HB 4743 was passed to engrossment by (Record 1712): 141 Yeas, 0 Nays, 1 Present, not voting.

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

  • Yea: 141 (published)
  • Nay: 0 (published)
  • Present, not voting: 1 (published)
  • Absent: 4 (derived from named list)
  • Excused: 4 (derived from named list)

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

Witnesses19
For
18
Against
0
On
1
Names

For

  • AARP Texas1 registration
  • Self1 registration
  • Self; Texas Medical Association1 registration
  • Self; Texas neurolgocal society1 registration
  • Self; Texas Neurological Society1 registration
  • Teaching Hospitals of Texas1 registration
  • Teaching hospitals of texas1 registration
  • Texas Chapter American College of Physicians2 registrations
  • Texas Hospital Association2 registrations
  • Texas medical assn.1 registration
  • Texas Medical Association3 registrations
  • Texas Neurological Society2 registrations
  • University Medical Center of El Paso1 registration

On

  • HHSC1 registration
Sources

19 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 E · source

Sources

Fiscal note · version E · May 19, 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 13, 2025

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.

Sponsors
Cosponsors

House committee · Public Health · Committee vote 12 aye, 0 nay, 1 absent · Out of committee

Senate committee · Health & Human Services · Committee vote 8 aye, 0 nay, 1 absent · Out of committee

Companion

SB 2479 by Campbell (identical)

Subjects

Health--Other Diseases & Medical Conditions

Hospitals

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 517 words

89R14531 MPF-D

By: Bonnen
H.B. No. 4743

A BILL TO BE ENTITLED

AN ACT

relating to the issuance of a single license for a hospital and a

mobile stroke unit of the hospital.

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

SECTION 1. Section 241.023, Health and Safety Code, is

amended by amending Subsections (c-1) and (c-2) and adding

Subsection (h) to read as follows:

(c-1) The department may issue :

(1) one license for multiple hospitals if:

(A) [ (1) ] all buildings in which inpatients

receive hospital services and inpatient services of each of the

hospitals to be included in the license are subject to the control

and direction of the same governing body;

(B) [ (2) ] all buildings in which inpatients

receive hospital services are within a 30-mile radius of the main

address of the applicant;

(C) [ (3) ] there is integration of the organized

medical staff of each of the hospitals to be included in the

license;

(D) [ (4) ] there is a single chief executive

officer for all of the hospitals who reports directly to the

governing body and through whom all administrative authority flows

and who exercises control and surveillance over all administrative

activities of the hospital;

(E) [ (5) ] there is a single chief medical officer

for all of the hospitals who reports directly to the governing body

and who is responsible for all medical staff activities of the

hospital;

(F) [ (6) ] each building of a hospital to be

included in the license that is geographically separate from other

buildings of the same hospital contains at least one nursing unit

for inpatients, unless providing only diagnostic or laboratory

services, or a combination of diagnostic or laboratory services, in

the building for hospital inpatients; and

(G) [ (7) ] each hospital that is to be included in

the license complies with the emergency services standards:

(i) [ (A) ] for a general hospital, if the

hospital provides surgery or obstetrical care or both; or

(ii) [ (B) ] for a special hospital, if the

hospital does not provide surgery or obstetrical care ; and

(2) one license for a hospital and a mobile stroke unit

of the hospital if the mobile stroke unit is accredited by a health

care accreditation organization approved by the Centers for

Medicare and Medicaid Services .

(c-2) The department may recommend a waiver of the

requirement of Subsection (c-1)(1)(G) [ (c-1)(7) ] for a hospital if

another hospital that is to be included in the license:

(1) complies with the emergency services standards for

a general hospital; and

(2) is in close geographic proximity to the hospital.

(h) Subsection (g) does not apply to a license issued to a

mobile stroke unit of a hospital under Subsection (c-1)(2).

SECTION 2. As soon as practicable after the effective date

of this Act, the executive commissioner of the Health and Human

Services Commission shall adopt rules necessary to implement

Section 241.023(c-1), Health and Safety Code, as amended by this

Act.

SECTION 3. This Act takes effect September 1, 2025.