Bill Text: TX HB2430 | 2011-2012 | 82nd Legislature | Introduced
Bill Title: Relating to the price charged by a health care provider for a health care service or supply; providing penalties.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2011-03-14 - Referred to Public Health [HB2430 Detail]
Download: Texas-2011-HB2430-Introduced.html
82R7931 YDB-F | ||
By: Kolkhorst | H.B. No. 2430 |
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relating to the price charged by a health care provider for a health | ||
care service or supply; providing penalties. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. This Act may be cited as the Texas Health Care | ||
Pricing Disclosure Act. | ||
SECTION 2. The heading to Subchapter H, Chapter 101, | ||
Occupations Code, is amended to read as follows: | ||
SUBCHAPTER H. BILLING AND PRICING INFORMATION | ||
SECTION 3. Subchapter H, Chapter 101, Occupations Code, is | ||
amended by adding Section 101.3515 to read as follows: | ||
Sec. 101.3515. PRICING INFORMATION. (a) In this section: | ||
(1) "Bundled health care services and supplies" means | ||
for pricing purposes the grouping of multiple health care services | ||
and supplies provided by a health care provider to a patient during | ||
one visit to or treatment by the provider. | ||
(2) "Health care price" means the total amount of | ||
compensation a health care provider accepts as payment in full for a | ||
health care service or supply or bundled health care services and | ||
supplies provided to a patient. | ||
(3) "Health care provider" means: | ||
(A) a health care professional who performs a | ||
health care service or provides a health care supply in this state | ||
under a license, certificate, registration, or other authority | ||
issued by this state to diagnose, prevent, alleviate, or cure a | ||
human illness or injury, including a physician and dentist; | ||
(B) a health care facility that provides a health | ||
care service or supply in this state under a license, certificate, | ||
registration, or other authority issued by this state to diagnose, | ||
prevent, alleviate, or cure a human illness or injury, including an | ||
institutional health care provider; or | ||
(C) a person that provides to patients in this | ||
state ancillary health care-related services and supplies under a | ||
license, certificate, or registration issued by this state, or that | ||
is otherwise authorized to provide to patients in this state | ||
ancillary health care-related services and supplies ordered or | ||
authorized by a licensed health care professional, to diagnose, | ||
prevent, alleviate, or cure a human illness or injury, including | ||
laboratory services, radiological services, and durable medical | ||
equipment. | ||
(4) "Pricing information list" means a list of: | ||
(A) the health care price of each health care | ||
service and each health care supply that may be provided by a health | ||
care provider to a patient; and | ||
(B) the health care price of each set of bundled | ||
health care services and supplies that may be provided by the health | ||
care provider to a patient. | ||
(b) This section does not apply to a health care price of a | ||
health care service or supply or bundled health care services and | ||
supplies provided to: | ||
(1) a patient for whom a health care provider has | ||
accepted assignment for the health care service or supply from | ||
Medicaid or Medicare or any other federal, state, or local | ||
government-sponsored medical assistance program; or | ||
(2) a financially or medically indigent person who | ||
qualifies for indigent health care services based on: | ||
(A) a sliding fee scale; or | ||
(B) a health care provider's written charity care | ||
policy. | ||
(c) Each health care provider shall: | ||
(1) compile a pricing information list; | ||
(2) post on the provider's Internet website the | ||
pricing information list and the effective date of the list before | ||
providing a health care service or supply or bundled health care | ||
services and supplies to a patient; and | ||
(3) not less than 30 days before changing the health | ||
care price of a health care service or supply or bundled health care | ||
services and supplies provided by the provider to the patient, | ||
provide notice of the price change by posting the notice on the | ||
provider's Internet website. | ||
(d) A health care provider may not: | ||
(1) charge an amount that is different from the amount | ||
listed as the health care price in the pricing information list for | ||
a health care service or supply or bundled health care services and | ||
supplies provided to a patient; or | ||
(2) include a discount, bonus, fee, or other charge | ||
that changes the health care price listed in the pricing | ||
information list. | ||
(e) A health care provider may accept from a patient a | ||
payment that is less than the health care price listed in the | ||
pricing information list if the health care provider determines, in | ||
the provider's sole discretion, that payment of the listed price | ||
would present a hardship to the patient. | ||
(f) Except for a health care service or supply or bundled | ||
health care services and supplies provided to a patient in an | ||
emergency department of a hospital or as a result of an emergent | ||
direct admission, a patient who receives a health care service or | ||
supply or bundled health care services and supplies from a health | ||
care provider whose health care price listed is greater than the | ||
payment provided under the patient's health plan is personally | ||
responsible for the amount that exceeds the listed price. | ||
(g) A health care provider that violates this section is | ||
subject to an administrative penalty, a civil penalty, or other | ||
disciplinary action, as applicable, in the same manner as if the | ||
provider violated the law under which the provider is licensed, | ||
certified, registered, or authorized. | ||
SECTION 4. Section 101.352(a), Occupations Code, is amended | ||
to read as follows: | ||
(a) A physician shall develop, implement, and enforce | ||
written policies for the billing of health care services and | ||
supplies. The policies must address: | ||
(1) [ |
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services or supplies provided to an indigent patient who qualifies | ||
for services or supplies based on a sliding fee scale or a written | ||
charity care policy established by the physician; | ||
(2) [ |
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billed health care service or supply not covered by a third-party | ||
payor and the rate of any interest charged; and | ||
(3) [ |
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relating to billed charges for health care services or supplies. | ||
SECTION 5. Section 324.101(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) Each facility shall develop, implement, and enforce | ||
written policies for the billing of facility health care services | ||
and supplies. The policies must address: | ||
(1) [ |
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a financially or medically indigent consumer who qualifies for | ||
indigent services based on a sliding fee scale or a written charity | ||
care policy established by the facility and the documented income | ||
and other resources of the consumer; | ||
(2) [ |
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service not covered by a third-party payor and the rate of any | ||
interest charged; and | ||
(3) [ |
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SECTION 6. Sections 324.101(b) and (d), Health and Safety | ||
Code, are repealed. | ||
SECTION 7. Notwithstanding Section 101.3515, Occupations | ||
Code, as added by this Act, Section 101.352, Occupations Code, as | ||
amended by this Act, or Section 324.101, Health and Safety Code, as | ||
amended by this Act, a health care provider is not required to | ||
comply with the changes in law made by those sections until | ||
September 1, 2012. | ||
SECTION 8. This Act takes effect September 1, 2011. |