According to the Legislative Budget Board (LBB), SB 916 is not expected to have a significant fiscal impact on the State of Texas. The bill’s provisions, which empower the Department of State Health Services (DSHS) to take enforcement actions against emergency medical services (EMS) providers for certain billing violations, are anticipated to be implemented using existing agency resources. No new appropriations or major budget reallocations are foreseen as necessary for the bill's execution.

Additionally, the bill is projected to have no significant fiscal implications for local governments. While it allows political subdivisions to adjust EMS reimbursement rates within specified limits, these changes are not expected to result in meaningful budgetary burdens or revenue shifts at the local level. The regulatory updates primarily reinforce oversight and standardize rate adjustments without mandating spending increases.

Overall, SB 916 is designed to improve consumer protections and billing transparency within the EMS sector without imposing material costs on state or local entities.

SB 916 builds upon prior efforts to protect Texas consumers from the financially burdensome practice of balance billing in emergency medical services. Following the 2019 passage of SB 1264, which tackled surprise medical billing but excluded municipal ambulance services, the author successfully introduced SB 2476 in 2023 to address this gap. However, because SB 2476 was enacted with an expiration date of September 1, 2025, SB 916 now seeks to extend these consumer protections through 2027, ensuring continued safeguards against exploitative billing practices during urgent medical transport.

In addition to extending the sunset date, the bill gives the Department of State Health Services (DSHS) new authority to enforce compliance by EMS providers, including the ability to revoke or suspend licenses for intentional misreporting or repeated violations. It also ensures rate adjustments by political subdivisions for EMS reimbursement remain within defined inflationary limits (capped at the Medicare Ambulance Inflation Factor or 10 percent). This encourages both fiscal discipline and rate predictability for healthcare payers.

Importantly, the Legislative Budget Board concluded that SB 916 has no significant fiscal impact on the state or local governments, and implementation costs can be absorbed within existing resources. Taken together, the bill upholds several core liberty principles by promoting transparency, curbing coercive financial practices, and ensuring limited, targeted government intervention. For these reasons, Texas Policy Research recommends that lawmakers vote YES on SB 916.

• HB 4054 (Same As)