S.B. No. 457 aims to enhance the regulation of nursing facilities in Texas by introducing new licensing requirements and improving Medicaid participation and reimbursement processes. A key addition to the Government Code is Section 532.0159, which ensures that nursing facilities will continue to receive uninterrupted Medicaid reimbursement during a change in ownership application, provided the new owner accepts the previous owner's Medicaid provider agreement and enters into a successor liability agreement. The bill also mandates that nursing facility provider agreements comply with a patient care expense ratio, ensuring that a significant portion of Medicaid reimbursements is directed towards patient care expenses.

In addition to these provisions, the bill amends existing laws to streamline Medicaid reimbursement processes, requiring nursing facilities to be paid within ten days of submitting a clean claim. It also includes requirements for reporting ownership interests in nursing facilities and mandates the Health and Human Services Commission to evaluate the impact of these changes on care quality by November 1, 2027. The bill establishes a protocol for state agencies to request necessary federal waivers or authorizations before implementing its provisions and is set to take effect on September 1, 2025, following strong legislative support in both the Senate and House.

Statutes affected:
Introduced: Health and Safety Code 242.032, Human Resources Code 32.028 (Health and Safety Code 242, Human Resources Code 32)
Senate Committee Report: Government Code 540.0752, Health and Safety Code 242.032, Human Resources Code 32.028 (Government Code 540, Health and Safety Code 242, Human Resources Code 32)
Engrossed: Government Code 540.0752, Health and Safety Code 242.032, Human Resources Code 32.028 (Government Code 540, Health and Safety Code 242, Human Resources Code 32)
House Committee Report: Government Code 540.0752, Health and Safety Code 242.032, Human Resources Code 32.028 (Government Code 540, Health and Safety Code 242, Human Resources Code 32)
Enrolled: Government Code 540.0752, Health and Safety Code 242.032, Human Resources Code 32.028 (Government Code 540, Health and Safety Code 242, Human Resources Code 32)