H.B. No. 2587 introduces a new requirement for the Health and Human Services Commission to prepare an annual report detailing the financial impact on hospitals that provide uncompensated care to individuals not lawfully present in the United States. The bill adds Section 525.0304 to the Government Code, defining key terms such as "financial impact," "hospital," and "person not lawfully present." The report must be submitted to the governor and the legislature by November 1 each year, covering the preceding state fiscal year. Hospitals will be required to include questions about patients' citizenship or immigration status on their intake forms and to submit quarterly reports on emergency room visits and inpatient discharges for those patients.

Additionally, the bill mandates that the reports must not contain any personal identifying information, ensuring patient confidentiality. The executive commissioner is tasked with adopting the necessary rules to implement these requirements, with the first report not due until December 1, 2026, despite the law taking effect on September 1, 2025. This legislation aims to provide transparency regarding the financial burden on hospitals due to uncompensated care for individuals who are not legally present in the country.

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