LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 31, 2025 TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB331 by Kolkhorst (Relating to the disclosure of health care cost information by certain health care facilities; imposing an administrative penalty.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for SB331, As Introduced: a negative impact of ($651,207) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026($334,875)2027($316,332)2028($316,772)2029($2,970,452)2030($2,820,152)All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Savings/(Cost) fromGR Match For Medicaid758 Probable Savings/(Cost) fromFederal Funds555 Change in Number of State Employees from FY 20252026($334,875)$0$02.02027($316,332)$0$02.02028($316,772)$0$02.02029($2,946,717)($23,735)($24,277)17.52030($2,797,930)($22,222)($22,729)17.5 Fiscal AnalysisThis bill amends the Health and Safety Code to expand the type of facilities that are subject to price disclosure requirements. This bill takes effect immediately if it receives a vote of two-thirds of all the members elected to each house. Otherwise, this bill would take effect September 1, 2025. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 31, 2025 TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB331 by Kolkhorst (Relating to the disclosure of health care cost information by certain health care facilities; imposing an administrative penalty.), As Introduced TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB331 by Kolkhorst (Relating to the disclosure of health care cost information by certain health care facilities; imposing an administrative penalty.), As Introduced Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services Jerry McGinty, Director, Legislative Budget Board Jerry McGinty, Director, Legislative Budget Board SB331 by Kolkhorst (Relating to the disclosure of health care cost information by certain health care facilities; imposing an administrative penalty.), As Introduced SB331 by Kolkhorst (Relating to the disclosure of health care cost information by certain health care facilities; imposing an administrative penalty.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for SB331, As Introduced: a negative impact of ($651,207) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. Estimated Two-year Net Impact to General Revenue Related Funds for SB331, As Introduced: a negative impact of ($651,207) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five- Year Impact: 2026 ($334,875) 2027 ($316,332) 2028 ($316,772) 2029 ($2,970,452) 2030 ($2,820,152) All Funds, Five-Year Impact: 2026 ($334,875) $0 $0 2.0 2027 ($316,332) $0 $0 2.0 2028 ($316,772) $0 $0 2.0 2029 ($2,946,717) ($23,735) ($24,277) 17.5 2030 ($2,797,930) ($22,222) ($22,729) 17.5 Fiscal Analysis This bill amends the Health and Safety Code to expand the type of facilities that are subject to price disclosure requirements. This bill takes effect immediately if it receives a vote of two-thirds of all the members elected to each house. Otherwise, this bill would take effect September 1, 2025. Methodology This bill requires facilities to come into compliance with price transparency requirements by August 2029. The Health and Human Services Commission (HHSC) assumes the implementation and ramp up of health care facility price transparency would need to begin in fiscal year 2026 to ensure facilities are in compliance with the provisions of this bill by fiscal year 2029. The agency anticipates needing to begin the implementation process in fiscal year 2026 due to the expanded list of facilities and current workload requirements with hospital price transparency. The majority of costs and full-time-equivalents (FTEs) would be realized starting in fiscal year 2029 as the FTEs primary functions are to ensuring compliance with the price transparency requirements and processing enforcement actions on facilities, including hospital, freestanding emergency medical care facility, urgent care or retail clinic, outpatient clinic, birthing center, ambulatory surgical center, or other facility that is licensed to provide health care services in this state.This analysis assumes the HHSC would require $334,875 from the General Revenue Fund ($334,875 from All Funds) and 2.0 FTEs in fiscal year 2026 and $316,332 from the General Revenue Fund ($316,332 from All Funds) and 2.0 FTEs in fiscal year 2027 to implement the provisions of the bill, which include ensuring compliance with the price transparency requirements and processing enforcement actions. Included in the amounts above are assumed FTE costs totaling $$334,875 from the General Revenue Fund ($334,875 from All Funds) and 2.0 FTEs in fiscal year 2026 and $316,332 from the General Revenue Fund ($316,332 from All Funds) and 2.0 FTEs in fiscal year 2027. This includes $19,388 from the General Revenue Fund ($19,388 from All Funds) in fiscal year 2026 and $154,058 from the General Revenue Fund ($155,637 from All Funds) in fiscal year 2029 for one-time costs related to the implementation of provisions of this bill.According to the Comptroller of Public Accounts, the number of violations from the facilities added to this chapter that could be subject to an administrative penalty and the number of violations resulting from the new price disclosure deadline are unknown; therefore, the fiscal impact on the state cannot be estimated. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: b > td > 304 Comptroller of Public Accounts, 529 Health and Human Services Commission 304 Comptroller of Public Accounts, 529 Health and Human Services Commission LBB Staff: b > td > JMc, NPe, ER, LBl JMc, NPe, ER, LBl