50-state desk · TX

Texas

Process / partial

Nonprofit hospitals must provide charity care and community benefits and report them — but Texas does not set a patient-level FPL write-off floor. Texas has not expanded Medicaid. Providers can lose the right to collect certain charges if they miss billing deadlines (often discussed as an 11-month claims window). Four-year lawsuit window. Homestead is strongly protected.

Tex. Health & Safety Code §§ 311.031–311.048 (charity care / community benefits) · compiled September 2026

RuleThis state
Free-care floor
Discount / eligibility floor
Covers insured patientsYes, if they otherwise qualify
Which hospitalsNonprofit / 501(c)(3) hospitals via federal 501(r)
Medicaid expansionNot adopted
Screen before collectionsNot required by state law
Credit reportsNo state ban
Debt salesNot banned
Home liensNot banned
Wage garnishmentFederal CCPA cap (typically 25%)
Interest on medical debtNo special cap located
Collection holdNo extra state waiting period
Lawsuit clock4 years · Tex. Civ. Prac. & Rem. Code § 16.004; debt-buyer revival limits in Tex. Fin. Code § 392.307

2026 poverty line here

Alaska and Hawaii use their own HHS tables. Everyone else uses the 48-state and D.C. figures, effective January 2026.

Household100%Free floorDiscount floor
1$15,960
2$21,640
3$27,320
4$33,000
5$38,680
6$44,360

What to do

  1. 01 Texas has no 400% statute. Download that nonprofit’s charity-care policy — Chapter 311 requires them to have one.
  2. 02 If you are a childless adult under poverty, you are likely in the Medicaid gap. FAP is the path.
  3. 03 Ask whether they billed in time. Stale hospital claims are a real Texas defense.
  4. 04 Four-year lawsuit window. Debt buyers cannot easily revive time-barred debt. Homestead is well protected — do not put the house on a payment plan.

Appeals

Texas surprise-billing / mediation (TDI) plus the No Surprises Act.

Insurance: Texas Department of Insurance — surprise billing / external review

Medicaid: HHSC fair hearing. Adult coverage is categorical — there is a coverage gap.

Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.

Cite this in a letter

If you are a nonprofit hospital, I request charity care under your policy adopted to satisfy Texas Health and Safety Code Chapter 311, and a FAP determination under Internal Revenue Code section 501(r). Please also confirm this account was billed within any applicable timely-billing limit.
TX

Put a Texas bill in the machine.

The estimate will use this state’s floors. The letters will cite Tex. Health & Safety Code §§ 311.031–311.048 (charity care / community benefits).

Start a Texas case

Texas Attorney General

Federal overlay — every state

  • 501(r)

    501(c)(3) hospital organizations must publish a Financial Assistance Policy, a plain-language summary, and generally may not take extraordinary collection actions (selling the debt, reporting it, liens, lawsuits) until they have made reasonable efforts to determine FAP eligibility.

  • No Surprises Act

    Emergency services, air ambulance, and many out-of-network clinicians at in-network facilities cannot balance-bill beyond in-network cost-sharing. Independent dispute resolution is between the plan and the provider — not a reason to pay the sticker rate.

  • FDCPA

    15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until validated, collection and credit reporting should stop. Partial payment can restart a state’s statute of limitations.

  • EMTALA

    Emergency departments must screen and stabilize regardless of ability to pay. An ER bill is not an agreement that chargemaster rates are the cash price.

  • Medicare appeals

    Five levels: redetermination (MAC, 120 days), reconsideration (QIC), ALJ at OMHA, Medicare Appeals Council, then federal district court. A remaining patient balance is often a claim the provider still needs to work.

  • Credit bureaus

    The CFPB’s 2025 medical-debt reporting rule was vacated in July 2025. Industry practice still generally omits paid medical collections and unpaid balances under $500. Unpaid medical debt over $500 can appear after a delay unless a state ban applies. FCRA-preemption fights over those state bans are ongoing.