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. |