Monitoring the Session

HB 475

bill making Medicaid pay for multisystemic therapy

Did not pass

Verdict: No flags

No flagsInitial review
Rep. Ann JohnsonDHouse 134

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 Medicaid coverage and reimbursement for multisystemic therapy services.

Caption from analyzed text · version I.

Summary

Providers get their own category so they can enroll and bill.

The bill requires the Texas Medicaid program to pay health care providers who deliver multisystemic therapy, as identified by a standard federal billing code, to Medicaid patients. It also directs the state's health commission chief to create a separate provider category for multisystemic therapy providers so they can enroll in and bill Medicaid. If a federal waiver is needed, the state must ask for it and may hold off until it is granted, and the law otherwise takes effect September 1, 2025.

Labels

Labels: ZOMBIE BILL. Died 2 times: 88R HB 2638 (Died in committee) and this bill (Did not pass). Checked against 88R only.DO-OVER. Reworked text of a bill filed before that died: 88R HB 2638 (Died in committee). Filed in 2 sessions, counting this one. Checked against 88R only.TRY NO. 2. Filed in 2 sessions: 88R and 89R. Checked against 88R only.ACROSS THE AISLE. Joint authors: 1 Republican, 4 Democrats. Party as the Legislative Reference Library lists it for the 89th Legislature.GOT HALFWAY. Passed the House on May 16, 2025. Died in the Senate: received, never referred to a committee.

Receipt

The receipt

89R-HB475 · 2024-11-12

SOLD BY

Rep. Ann JohnsonDHouse 134 Rep. Dade PhelanRHouse 21 Rep. Senfronia ThompsonDHouse 141

+ 2 more authors

ITEM

relating to Medicaid coverage and reimbursement for multisystemic therapy services.

WHAT IT DOES

Providers get their own category so they can enroll and bill.

The bill requires the Texas Medicaid program to pay health care providers who deliver multisystemic therapy, as identified by a standard federal billing code, to Medicaid patients. It also directs the state's health commission chief to create a separate provider category for multisystemic therapy providers so they can enroll in and bill Medicaid. If a federal waiver is needed, the state must ask for it and may hold off until it is granted, and the law otherwise takes effect September 1, 2025.

CHARGES

[ ] NONE FOUND

TOTAL

Net to General Revenue · FY 2026($240,530)

LBB estimate, flow · fiscal note version I · ( ) = negative · source

Sources

Fiscal note · version I · April 16, 2025

Estimated Two-year Net Impact to General Revenue Related Funds for HB475, As Introduced: a negative impact of ($4,051,948) through the biennium ending August 31, 2027.

First year · FY 2026 · ($240,530)

Probable Net Positive/(Negative) Impact to General Revenue Related Funds

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 s/c on Dis Prev & Women's & Children's Health by Speaker
  4. Scheduled for public hearing in s/c on . . .
  5. Considered by s/c in public hearing
  6. Testimony taken/registration(s) recorded in subcommittee
  7. Left pending in subcommittee
  8. Recalled from subcommittee
  9. Considered in formal meeting
  10. Reported favorably w/o amendment(s)
  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. Passed to engrossment
  18. Record vote RV#2759
  19. Statement(s) of vote recorded in Journal
  20. Read 3rd time
  21. Postponed 5/16/25 12:35 PM
  22. Laid out as postponed business
  23. Passed
  24. Record vote RV#2890
  25. Statement(s) of vote recorded in Journal
  26. Reported engrossed
  27. Received from the House
FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 99 yea · 23 nay

Sources

House: Final passage · May 16, 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

Ann Johnson

Donors

Texas Trial Lawyers Association PAC$73KTexans for Truth and Liberty PAC$65KAgave Democratic Infrastructure Fund$55K

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.

Texas Trial Lawyers Association PAC$72,500.00

Texas Trial Lawyers Association PAC

$72,500.00

Cash
$72,500.00
Paid by others
$0.00
Total
$72,500.00

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 · Dec 10, 2024 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: 100987008, 101008094, 101030169, 101058089, 101072095.

Texans for Truth and Liberty PAC$65,000.00

Texans for Truth and Liberty PAC

$65,000.00

Cash
$65,000.00
Paid by others
$0.00
Total
$65,000.00

Also funds 44 other sitting lawmakers.

Derived recipient stock · Jun 24, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 26, 2025 to Oct 15, 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: 101008094, 101072095.

Agave Democratic Infrastructure Fund$54,875.00

Agave Democratic Infrastructure Fund

$54,875.00

Cash
$25,000.00
Paid by others
$29,875.00
Total
$54,875.00
consulting $29,875.00

Also funds 5 other sitting lawmakers.

Derived recipient stock · Nov 22, 2024 to Oct 12, 2026. State data as of Nov 4, 2026.

TEC account match.

Sources

Derived itemized flow · Nov 22, 2024 to Oct 12, 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: 100987008, 101058089, 101068643, 101072095.

Money

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

×

Texas Trial Lawyers Association PAC

$72,500.00

Cash
$72,500.00
Paid by others
$0.00
Total
$72,500.00

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 · Dec 10, 2024 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: 100987008, 101008094, 101030169, 101058089, 101072095.

×

Texans for Truth and Liberty PAC

$65,000.00

Cash
$65,000.00
Paid by others
$0.00
Total
$65,000.00

Also funds 44 other sitting lawmakers.

Derived recipient stock · Jun 24, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 26, 2025 to Oct 15, 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: 101008094, 101072095.

×

Agave Democratic Infrastructure Fund

$54,875.00

Cash
$25,000.00
Paid by others
$29,875.00
Total
$54,875.00
consulting $29,875.00

Also funds 5 other sitting lawmakers.

Derived recipient stock · Nov 22, 2024 to Oct 12, 2026. State data as of Nov 4, 2026.

TEC account match.

Sources

Derived itemized flow · Nov 22, 2024 to Oct 12, 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: 100987008, 101058089, 101068643, 101072095.

Votes2

House May 16, 2025

Yea
99
Nay
23
Present, not voting
2
Absent
7
Excused
19
Names

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

House journal

Sources

Record 2890

HB 475 was passed by (Record 2890): 99 Yeas, 23 Nays, 2 Present, not voting.

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

  • Yea: 99 (published)
  • Nay: 23 (published)
  • Present, not voting: 2 (published)
  • Absent: 7 (derived from named list)
  • Excused: 19 (derived from named list)

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

House May 15, 2025

Yea
80
Nay
58
Present, not voting
2
Absent
5
Excused
5
Names

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

House journal

Sources

Record 2759

HB 475 was passed to engrossment by (Record 2759): 80 Yeas, 58 Nays, 2 Present, not voting.

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

  • Yea: 80 (published)
  • Nay: 58 (published)
  • Present, not voting: 2 (published)
  • Absent: 5 (derived from named list)
  • Excused: 5 (derived from named list)

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

Witnesses32
For
29
Against
0
On
3
Names

For

  • Behavioral Health Advocates of Texas1 registration
  • Bexar County Commissioners Court1 registration
  • Children’s Hospital Assn of Texas1 registration
  • City of Houston1 registration
  • Clarity Child Guidance Center1 registration
  • Driscoll Health System1 registration
  • El Paso County1 registration
  • Harris County Commissioners Court1 registration
  • Meadows Mental Health Policy Institute1 registration
  • Methodist Healthcare Ministries1 registration
  • NAMI Texas1 registration
  • National Association of Social Workers- Texas Chapter1 registration
  • Self; Lubbock County Juvenile Probation1 registration
  • Self; Mental Health America of Greater Houstom1 registration
  • Self; Texas Academy of Family Physicians and Texas Primary Care Consortium1 registration
  • Self; Texas Association of Community Health Centers (TACHC)1 registration
  • Texans Care for Children1 registration
  • Texas Association of Health Plans1 registration
  • Texas CASA1 registration
  • Texas Children’s Hospital1 registration
  • Texas Civil Rights Project1 registration
  • Texas Health Resources1 registration
  • Texas Hospital Association1 registration
  • Texas Impact1 registration
  • Texas Medical Association1 registration
  • Texas Network of Youth Services1 registration
  • Texas Pediatric Society1 registration
  • TexProtects1 registration
  • United Ways of Texas1 registration

On

  • HHSC1 registration
  • Self; Texas Counseling Association1 registration
  • Texas Counseling Association1 registration
Sources

32 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
Net to General Revenue · FY 2026($240,530)

LBB estimate, flow · fiscal note version I · ( ) = negative · source

Sources

Fiscal note · version I · April 16, 2025

Estimated Two-year Net Impact to General Revenue Related Funds for HB475, As Introduced: a negative impact of ($4,051,948) through the biennium ending August 31, 2027.

First year · FY 2026 · ($240,530)

Probable Net Positive/(Negative) Impact to General Revenue Related Funds

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.

FILED BEFORE

Filed 2 times: 88R and 89R. Checked against 88R only.

88R HB 2638

by Rep. Ann Johnson, same lead author · Died in committee · reworked

Introduced text

Last action, May 1, 2023: Referred to Health & Human Services

Relating to Medicaid coverage and reimbursement for multisystemic therapy services.

Caption, 88R bill history

Sources

Texas House · Filed Nov 12, 2024

05/19/2025 S Received from the House

Texas Legislature Online · Introduced · House Committee Report · Engrossed

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

House committee · Public Health · Committee vote 10 aye, 3 nay · Out of committee

Subjects

Human Services--Child Services

Human Services--Medical Assistance

Mental Health & Substance Abuse

MEDICAID

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 181 words

89R1445 SCF-D

By: Johnson
H.B. No. 475

A BILL TO BE ENTITLED

AN ACT

relating to Medicaid coverage and reimbursement for multisystemic

therapy services.

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

SECTION 1. Section 32.024, Human Resources Code, is amended

by adding Subsection (oo-1) to read as follows:

(oo-1) The commission shall provide medical assistance

reimbursement to a health care provider who delivers services

classified as multisystemic therapy by the Healthcare Common

Procedure Coding System (HCPCS) code to a recipient under the

medical assistance program. The executive commissioner shall

establish a separate provider type for multisystemic therapy

providers for purposes of enrollment as a provider for and

reimbursement under the medical assistance program.

SECTION 2. If before implementing any provision of this Act

a state agency determines that a waiver or authorization from a

federal agency is necessary for implementation of that provision,

the agency affected by the provision shall request the waiver or

authorization and may delay implementing that provision until the

waiver or authorization is granted.

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