In accordance with Executive Order No. GA-46, issued by Governor Greg Abbott on Aug. 8, 2024, hospital providers must ask each patient during the hospital intake process whether the patient is (1) a citizen or an alien lawfully present in the United States or (2) an alien not lawfully present in the United States. Hospital providers must report quarterly to HHSC the number of inpatient discharges and emergency visits by all patients, including those who are (1) a citizen or an alien lawfully present in the United States and (2) an alien not lawfully present in the United States. Hospital providers must also report quarterly to HHSC the costs of care for patients not lawfully present in the United States. Hospitals began collecting this information on Nov. 1, 2024, and will begin reporting to HHSC on March 1, 2025.
When collecting information about a patient’s immigration status, hospital providers must provide notification that the response will not affect patient care, as required by federal law.
Information must be provided for all applicable months each time data is submitted. Therefore, data for previously reported months must be updated or provided again as appropriate.
Hospitals must submit the Executive Order GA-46 Form following the reporting timelines below:
- Due March 1, 2025 – Information for Sept., Oct., and Nov. (For this first year, there will be no reporting for Sept. or Oct.).
- Due June 1, 2025 – Information for Nov. through Feb.
- Due Sept. 1, 2025 – Information for Nov. through May
- Due Dec. 1, 2025 – Information for Nov. through Aug.
- Jan. 1, 2026 – HHSC will report to the Governor, Lt. Governor, and Speaker of the House on the preceding year’s costs.
As of April 9, 2025, HHSC has updated the Executive Order GA-46 Reporting Form. The updated version is available on our website: Hospitals & Clinic Services Executive Order GA-46 Form
Notable Modifications:
- Added instruction page for clarification.
- Removed the signature requirement
- Added separate buttons for “Save” and “Submit” to improve clarity.
- The save button will prompt you to save directly onto your PC.
- The submit button will create an email to send the form directly to our email box: submission@hhs.texas.gov
Before using the form, check for the most current version on the HHSC website.
Be aware that some features of the form may not work in an internet browser. If the form opens in an internet browser, download or save it locally and open it in a PDF reader (Adobe).
When submitting updated data from the previous quarter, submit the total amount for each month. Also, indicate in the appropriate box that the form includes updates for the previous quarter.
