82R20325 YDB-D
By: Truitt H.B. No. 2576
Substitute the following for H.B. No. 2576:
By: Kolkhorst C.S.H.B. No. 2576
A BILL TO BE ENTITLED
AN ACT
relating to a disclosure statement on the out-of-pocket costs
incurred for health care services and supplies provided to
consumers receiving outpatient care at a hospital outpatient
clinic.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. 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) any discounting of facility charges to an
uninsured consumer, subject to Chapter 552, Insurance Code;
(2) any discounting of facility charges provided to 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;
(3) the providing of an itemized statement required by
Subsection (e);
(4) whether interest will be applied to any billed
service not covered by a third-party payor and the rate of any
interest charged;
(5) the procedure for handling complaints;
(6) the providing of a conspicuous written disclosure
to a consumer at the time the consumer is first admitted to the
facility or first receives services at the facility that:
(A) provides confirmation whether the facility
is a participating provider under the consumer's third-party payor
coverage on the date services are to be rendered based on the
information received from the consumer at the time the confirmation
is provided;
(B) informs consumers that a facility-based
physician who may provide services to the consumer while the
consumer is in the facility may not be a participating provider with
the same third-party payors as the facility;
(C) informs consumers that the consumer may
receive a bill for medical services from a facility-based physician
for the amount unpaid by the consumer's health benefit plan;
(D) informs consumers that the consumer may
request a listing of facility-based physicians who have been
granted medical staff privileges to provide medical services at
the facility; and
(E) informs consumers that the consumer may
request information from a facility-based physician on whether the
physician has a contract with the consumer's health benefit plan
and under what circumstances the consumer may be responsible for
payment of any amounts not paid by the consumer's health benefit
plan;
(7) the requirement that a facility provide a list, on
request, to a consumer to be admitted to, or who is expected to
receive services from, the facility, that contains the name and
contact information for each facility-based physician or
facility-based physician group that has been granted medical staff
privileges to provide medical services at the facility; [and]
(8) if the facility operates a website that includes a
listing of physicians who have been granted medical staff
privileges to provide medical services at the facility, the posting
on the facility's website of a list that contains the name and
contact information for each facility-based physician or
facility-based physician group that has been granted medical staff
privileges to provide medical services at the facility and the
updating of the list in any calendar quarter in which there are any
changes to the list; and
(9) for a health care service or supply provided on an
outpatient basis at a hospital outpatient clinic, the providing of
a conspicuous written disclosure statement to a consumer at the
time the consumer seeks outpatient care at the clinic that states:
"DEPENDING ON YOUR INSURANCE COVERAGE, YOU MAY INCUR MORE
OUT-OF-POCKET COSTS FOR A HEALTH CARE SERVICE OR SUPPLY PROVIDED AT
THIS CLINIC THAN YOU MIGHT OTHERWISE INCUR IF YOU RECEIVED THE
HEALTH CARE SERVICE OR SUPPLY AT A PHYSICIAN'S OFFICE."
SECTION 2. Section 324.101, Health and Safety Code, as
amended by this Act, applies only to a health care service or supply
provided at a hospital outpatient clinic on or after the effective
date of this Act.
SECTION 3. This Act takes effect September 1, 2011.