S.B. No. 457 aims to strengthen the regulation of nursing facilities in Texas by updating licensing requirements and Medicaid participation protocols. A key provision is the addition of Section 532.0159 to the Government Code, which ensures that nursing facilities undergoing a change in ownership can maintain uninterrupted Medicaid reimbursement, provided the new owner agrees to the previous owner's Medicaid provider agreement and enters into a successor liability agreement. Furthermore, Section 540.0283 mandates that provider agreements between Medicaid managed care organizations and nursing facilities adhere to a newly established patient care expense ratio, ensuring that a significant portion of Medicaid funds is directed towards patient care.

The bill also introduces Section 32.0286, which requires nursing facility providers to allocate at least 80% of their reimbursement for patient care expenses towards necessary care. The Health and Human Services Commission is responsible for implementing these provisions, including the adoption of necessary rules and the preparation of a report by November 1, 2027, to evaluate the impact of the new patient care expense ratio on the quality and cost of care for Medicaid recipients. Additionally, the bill outlines a process for state agencies to request federal waivers or authorizations when needed for implementation, with the act set to take effect on September 1, 2025. The bill has received strong bipartisan support, passing through both the Senate and House with no opposition in the Senate and a majority in the 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)