The patient bill of rights in Texas is not a single document but a set of protections drawn from state regulation, the Texas Health and Safety Code, and federal laws like EMTALA, HIPAA, and the No Surprises Act. Together they give you the right to respectful care, informed consent, emergency treatment regardless of ability to pay, access to your own records, protection from most surprise bills, interpreter and disability accommodations, and a free way to complain when a hospital or provider falls short. Every licensed Texas hospital must hand you a written copy of these rights at admission and post them next to its license.1Cornell Law Institute. Texas Administrative Code 25-117.42 – Patient Rights
What the Hospital Owes You at Admission
The core list lives in 25 Texas Administrative Code Section 117.42. Staff must treat you with respect and dignity, protect the privacy of your person and your clinical record, and give you information in a form you can actually understand.1Cornell Law Institute. Texas Administrative Code 25-117.42 – Patient Rights You keep the right to communicate with family or a legal representative during treatment, and the hospital must respect your cultural and personal values in how care is delivered.
The hospital must also tell you how to file a complaint, and it cannot cut off your services for using that process. Federal law adds an anti-discrimination layer: facilities that receive federal funding cannot discriminate based on race, color, national origin, or sex under Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act.2U.S. Department of Health and Human Services. Civil Rights Laws, Regulations, and Guidance for Providers of Health Care and Social Services
Emergency Room Rights
Walk into any Texas emergency department and the federal Emergency Medical Treatment and Labor Act takes over. Every Medicare-participating hospital with an ER must provide an appropriate medical screening examination when you ask for treatment for a possible emergency.3Centers for Medicare & Medicaid Services. Emergency Medical Treatment and Labor Act (EMTALA) If the screening shows an emergency condition, the hospital has to stabilize you using the staff and resources it has.4Office of the Law Revision Counsel. 42 U.S. Code 1395dd – Examination and Treatment for Emergency Medical Conditions
The hospital cannot delay the screening or stabilization to check your insurance or ask how you plan to pay.4Office of the Law Revision Counsel. 42 U.S. Code 1395dd – Examination and Treatment for Emergency Medical Conditions If it lacks what you need, it must treat you to the extent it can and arrange a transfer to a facility that has agreed to accept you, with qualified personnel, appropriate equipment, and your records sent along.
Informed Consent and the Right to Refuse
Before a procedure, your doctor has to tell you what it involves, the material risks, and reasonable alternatives. The Texas Medical Disclosure Panel, overseen by the Texas Health and Human Services Commission, keeps two lists: procedures that require disclosure of specific risks and hazards, and procedures that do not.5Texas Health and Human Services. Texas Medical Disclosure Panel For anything on the disclosure-required list, the specific risks have to be explained before you sign. The underlying informed consent rules sit in Chapter 74 of the Civil Practice and Remedies Code.
You can also say no. The right to refuse care is grounded in Texas statute and in broader principles of bodily autonomy. It has limits: Texas law allows treatment over objection when a patient lacks mental capacity, when a court-appointed guardian handles medical decisions, or when a physician determines medication is necessary to prevent imminent serious physical harm to the patient or someone else. Those exceptions move through proper legal channels, not a doctor’s unilateral call.
Your Medical Records
The Texas Medical Records Privacy Act in Chapter 181 of the Health and Safety Code is broader than federal HIPAA in several places. You have a right to copies of your health information after submitting a written authorization. Hospitals must make the records available no later than 15 days after they receive your request and any applicable fee.
Fees differ sharply depending on who holds the record. Under Section 241.154 of the Health and Safety Code, a hospital can charge up to $61.79 for the first 10 pages of paper records, $2.09 per page for pages 11 through 60, and $1.02 per page for pages 61 through 400. Electronic hospital records carry a retrieval fee of up to $111.94. The hospital cannot charge you to look at your records in person at the facility, and it cannot charge for an itemized statement of billed services.6Texas Health and Human Services Commission. Maximum Fees Allowed for Providing Health Care Information Records from a physician’s office are capped much lower by the Texas Medical Board: up to $25 for the first page of paper copies plus $0.25 per additional page, or up to $50 for records delivered digitally.7Cornell Law Institute. Texas Administrative Code 22-76.3 – Fees for Providing Patient Records
Fixing Errors in Your Chart
If something in your record is wrong or incomplete, federal rules at 45 CFR 164.526 give you the right to request an amendment. The provider has 60 days to act on it and can extend once by up to 30 days if it gives you a written reason for the delay.8eCFR. 45 CFR 164.526 – Amendment of Protected Health Information A denial has to come in writing with the reason, and you can submit a written statement of disagreement that stays with the record. You can also complain to the provider or to the U.S. Department of Health and Human Services.
Billing Protections
Surprise Bills
Senate Bill 1264, in effect since January 2020, protects Texans from balance billing in situations where you had no real choice of provider. If you get emergency care from an out-of-network doctor, or an out-of-network specialist treats you at an in-network facility, the most you can be charged is your in-network copayment, coinsurance, and deductible.9Texas Legislature Online. Texas Senate Bill 1264 – 86(R) The insurer and provider work out the rest through an independent dispute resolution process, with mediation for facility disputes and arbitration for individual provider disputes.10Texas Department of Insurance. Balance Billing – Independent Dispute Resolution Texas expanded the law in 2024 to cover emergency medical services and ground ambulance trips.
One major boundary: SB 1264 reaches state-regulated plans, including HMOs, PPOs, EPOs, and plans through the Employees Retirement System and Teacher Retirement System. It does not reach self-funded employer plans governed by the federal ERISA law. If your employer self-funds its coverage, your protection comes from the federal No Surprises Act instead.
Itemized Bills and Good Faith Estimates
You can demand an itemized hospital bill, and the hospital cannot charge for it. Under Chapter 185 of the Health and Safety Code, providers also must give you an itemized statement in plain-language terms before sending an unpaid bill to collections. That statement is where any billing dispute starts.
If you are uninsured or paying out of pocket, federal rules require a good faith estimate when you schedule care in advance or ask for one. If the final bill exceeds the estimate by $400 or more, you may be able to challenge it through a federal patient-provider dispute resolution process.11Centers for Medicare & Medicaid Services. Medical Bill Rights
Language and Disability Accommodations
Texas hospital rules require interpreter services and written materials in languages other than English when needed for you to understand your care and your rights.1Cornell Law Institute. Texas Administrative Code 25-117.42 – Patient Rights Staff must document in your chart how consent forms were explained and how you gave consent, which matters later if there is a dispute about what you actually understood.
Section 1557 of the Affordable Care Act layers on top. Healthcare entities must take reasonable steps to give meaningful access to anyone with limited English proficiency, and language services have to be free, accurate, timely, and protective of your privacy and independent decision-making. Interpreters must be proficient in both languages and able to interpret accurately and impartially.12U.S. Department of Health and Human Services. Language Access Provisions of the Final Rule Implementing Section 1557 of the Affordable Care Act
For patients who are deaf or hard of hearing, the Americans with Disabilities Act requires all private healthcare providers to furnish auxiliary aids and services for effective communication. That can mean qualified sign language interpreters, computer-aided transcription, captioning, or assistive listening devices. The obligation extends to a deaf companion such as a parent or guardian, and it applies no matter the size of the practice.
Advance Directives
Chapter 166 of the Health and Safety Code recognizes several ways to document your healthcare wishes before a crisis. The two most common are a directive to physicians, sometimes called a living will, which sets your preferences for end-of-life treatment, and a medical power of attorney, which names someone to make healthcare decisions for you if you cannot. Texas also recognizes out-of-hospital do-not-resuscitate orders.
Under the federal Patient Self-Determination Act, every hospital, skilled nursing facility, hospice, and HMO must tell you at admission about your right to create advance directives and must ask whether you already have one.13NCBI Bookshelf. Patient Self-Determination Act That information goes in your record, and no facility can discriminate based on whether you have a directive. A medical power of attorney gives your agent room to respond to unexpected situations; a directive to physicians locks in specific end-of-life choices. Many healthcare attorneys recommend having both.
How to File a Complaint
About a Doctor or Other Licensed Provider
Complaints about physicians, physician assistants, acupuncturists, and other professionals licensed by the Texas Medical Board go to the TMB. You can file electronically through its online portal, mail a paper form, or call the complaint hotline at 800-201-9353.14Texas Medical Board. Complaint About Licensee Include the practitioner’s full name, practice address, dates, and as much detail as you have. If an investigation moves forward and the Board finds a violation, it can issue a public reprimand, order additional education or monitoring, impose administrative fines, and suspend or revoke the license.
About a Hospital or Other Facility
Facility complaints go to a different agency: the Department of State Health Services. Texas rules require every hospital to tell admitted patients that complaints can be sent to the DSHS Health Facility Compliance Group at (888) 973-0022 or by mail.1Cornell Law Institute. Texas Administrative Code 25-117.42 – Patient Rights Many hospitals also run internal grievance processes you can use first or alongside the state complaint. For Medicare quality-of-care concerns, you can also file with the Beneficiary Family Centered Care Quality Improvement Organization.
Keep copies of medical records, bills, and any correspondence tied to the complaint. The more specific the paper trail, the stronger the basis for an investigation. Filing is free, and you can file anonymously, though staying anonymous may limit the agency’s ability to update you.