Bill Text: TX HB3020 | 2013-2014 | 83rd Legislature | Introduced
Bill Title: Relating to disclosure of 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) 2013-04-17 - Left pending in committee [HB3020 Detail]
Download: Texas-2013-HB3020-Introduced.html
| 83R5326 JSC-F | ||
| By: Sheffield of Coryell | H.B. No. 3020 | |
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| relating to disclosure of 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. | ||
| (b) Each health care provider shall compile a pricing | ||
| information list that lists the prices of certain frequently | ||
| performed services. A health care facility that provides inpatient | ||
| care shall list the prices for the 25 most frequently performed | ||
| procedures of each department in the facility based on the 25 most | ||
| frequently coded Diagnosis-Related Groups codes for that | ||
| department. A health care facility that provides outpatient care | ||
| shall list the prices for the 25 most frequently performed | ||
| procedures of each department in the facility based on the 25 most | ||
| frequently coded Ambulatory Payment Classification codes for that | ||
| department. A physician or other practitioner shall list the | ||
| prices for the 10 most frequently performed procedures of the | ||
| physician or other practitioner based on the 10 most frequently | ||
| coded Current Procedural Terminology codes. | ||
| (c) The health care provider may choose to disclose its | ||
| prices under Subsection (b) in either of the following formats: | ||
| (1) the prices of each health care service and each | ||
| health care supply; or | ||
| (2) the prices of each set of bundled health care | ||
| services and supplies. | ||
| (d) For each service in the pricing information list under | ||
| Subsection (b), a health care provider shall disclose: | ||
| (1) the highest charge the patient can expect to pay; | ||
| and | ||
| (2) the lowest discounted charge accepted for that | ||
| service from a payor. | ||
| (e) A health care provider shall make the provider's pricing | ||
| information list under Subsection (b) available to the public in | ||
| the form and manner determined by the provider. | ||
| (f) 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. | ||
| (g) Each health care provider shall: | ||
| (1) compile a pricing information list under | ||
| Subsection (b); | ||
| (2) post on the provider's Internet website or | ||
| otherwise make public 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 or by another method of publication or | ||
| dissemination that the provider uses for the list. | ||
| (h) 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 | ||
| under Subsection (b) 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 under Subsection (b). | ||
| (i) Notwithstanding Subsection (h), a health care provider | ||
| may accept or negotiate a payment that is less than the health care | ||
| price listed in the pricing information list under Subsection (b) | ||
| from an individual patient. A health care provider may not accept | ||
| or negotiate a payment that is less than the health care price | ||
| listed in the pricing information list under Subsection (b) from a | ||
| third party payor. | ||
| (j) 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. Notwithstanding Section 101.3515, Occupations | ||
| Code, as added by this Act, a health care provider is not required | ||
| to comply with the change in law made by that section until | ||
| September 1, 2014. | ||
| SECTION 5. This Act takes effect September 1, 2013. | ||
