Texas 2015 - 84th Regular

Texas House Bill HB3102 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	84R11368 AJA-D
2	2	By: Frullo H.B. No. 3102
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the disclosure by health care practitioners and
8	8	facilities of patient liability for payment for certain health care
9	9	services.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. The heading to Chapter 1456, Insurance Code, is
12	12	amended to read as follows:
13	13	CHAPTER 1456. DISCLOSURE OF PROVIDER STATUS AND PATIENT LIABILITY
14	14	SECTION 2. Section 1456.003(a), Insurance Code, is amended
15	15	to read as follows:
16	16	(a) Each health benefit plan that provides health care
17	17	through a provider network shall provide notice to its enrollees
18	18	that:
19	19	(1) a facility-based physician or other health care
20	20	practitioner may not be included in the health benefit plan's
21	21	provider network; and
22	22	(2) subject to Subchapter D, Chapter 324, Health and
23	23	Safety Code, a health care practitioner described by Subdivision
24	24	(1) may balance bill the enrollee for amounts not paid by the health
25	25	benefit plan.
26	26	SECTION 3. Section 1456.007, Insurance Code, is amended to
27	27	read as follows:
28	28	Sec. 1456.007. HEALTH BENEFIT PLAN ESTIMATE OF CHARGES. A
29	29	health benefit plan that must comply with this chapter under
30	30	Section 1456.002 shall, on the request of an enrollee, provide an
31	31	estimate of payments that will be made for any health care service
32	32	or supply and shall also specify any applicable deductibles,
33	33	copayments, or coinsurance[, or other amounts for which the
34	34	enrollee is responsible]. The estimate must be provided not later
35	35	than the 10th business day after the date on which the estimate was
36	36	requested. A health benefit plan must advise the enrollee that:
37	37	(1) the actual payment and charges for the services or
38	38	supplies will vary based upon the enrollee's actual medical
39	39	condition and other factors associated with performance of medical
40	40	services; and
41	41	(2) subject to Subchapter D, Chapter 324, Health and
42	42	Safety Code, the enrollee may be personally liable for the payment
43	43	of services or supplies based upon the enrollee's health benefit
44	44	plan coverage.
45	45	SECTION 4. Chapter 324, Health and Safety Code, is amended
46	46	by adding Subchapter D to read as follows:
47	47	SUBCHAPTER D. PRICE DISCLOSURE
48	48	Sec. 324.151. DEFINITIONS. Notwithstanding Section
49	49	324.001, in this subchapter:
50	50	(1) "Health care facility" means a hospital, emergency
51	51	clinic, outpatient clinic, birthing center, ambulatory surgical
52	52	center, or other facility providing health care services.
53	53	(2) "Health care practitioner" means an individual who
54	54	is licensed to provide and provides health care services.
55	55	Sec. 324.152. PRICE DISCLOSURE BY HEALTH CARE PRACTITIONERS
56	56	AND FACILITIES. (a) At least three business days before providing a
57	57	health care service other than emergency care, as defined by
58	58	Section 1301.155, Insurance Code, to a patient, a health care
59	59	practitioner or facility must disclose to the patient the price
60	60	that will be accepted as payment in full for the service. The
61	61	disclosure required by this section must be provided in writing in a
62	62	readily understandable manner.
63	63	(b) Notwithstanding another provision of this subchapter,
64	64	Chapter 1456, Insurance Code, or any other law, a health care
65	65	practitioner or facility that does not make a disclosure required
66	66	by this section before providing a health care service may not:
67	67	(1) attempt to collect from the patient, by lawsuit or
68	68	otherwise, any billed amount that would otherwise be owed by the
69	69	patient for the service;
70	70	(2) transfer or sell to a third party the right to
71	71	collect any billed amount that would otherwise be owed by the
72	72	patient for the service; or
73	73	(3) furnish adverse information to a consumer
74	74	reporting agency regarding any billed amount that would otherwise
75	75	be owed by the patient for the service.
76	76	Sec. 324.153. DUPLICATIVE ESTIMATE NOT REQUIRED. A
77	77	facility that receives a request for an estimate under Section
78	78	324.101(d) may provide, instead of an estimate, the price
79	79	disclosure required by this subchapter. A facility that provides
80	80	an estimate under Section 324.101(d) is not relieved of the
81	81	obligation to provide a price disclosure under this subchapter.
82	82	Sec. 324.154. PATIENT HELD HARMLESS. In addition to any
83	83	other remedy provided by this subchapter or other law, a health care
84	84	practitioner or facility shall hold a patient harmless from any
85	85	damages resulting from the practitioner's or facility's violation
86	86	of this subchapter.
87	87	SECTION 5. The change in law made by this Act applies only
88	88	to a service provided by a health care practitioner or facility on
89	89	or after January 1, 2016. A service provided by a health care
90	90	practitioner or facility before January 1, 2016, is governed by the
91	91	law in effect immediately before the effective date of this Act, and
92	92	that law is continued in effect for that purpose.
93	93	SECTION 6. This Act takes effect September 1, 2015.