H.B. No. 4408 introduces Chapter 550A to the Government Code, which establishes annual reporting requirements for ownership and control information of certain health care entities in Texas. The bill defines key terms such as "health care entity," "health care facility," and "health care provider," and outlines what constitutes "material change transactions," including corporate mergers and acquisitions for entities with assets or anticipated revenue of at least $10 million. It exempts independent provider organizations with three or fewer physicians from these reporting requirements, provided they are not owned or controlled by another entity. However, if such an exempt entity undergoes a material change transaction, it must comply with the reporting requirements thereafter.

The bill mandates that health care entities report detailed information to the Secretary of State, including their legal name, business address, ownership interests, and financial reports, to promote transparency and accountability. The Secretary of State is required to publish an annual report on their website regarding health care entities, including their business structures and any changes in ownership or control. The bill also grants the Secretary of State the authority to audit compliance and imposes civil penalties for non-compliance. H.B. No. 4408 is set to take effect on September 1, 2025, with the first annual report due by July 1, 2026.