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Texas Senate Bill SB2240

Texas 2017 - 85th Regular

Texas Senate Bill SB2240 Compare Versions

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11 By: Taylor of Galveston S.B. No. 2240
2- (In the Senate - Filed March 10, 2017; March 29, 2017, read
3- first time and referred to Committee on Business & Commerce;
4- April 24, 2017, reported adversely, with favorable Committee
5- Substitute by the following vote: Yeas 9, Nays 0; April 24, 2017,
6- sent to printer.)
7-Click here to see the committee vote
8- COMMITTEE SUBSTITUTE FOR S.B. No. 2240 By: Taylor of Galveston
92
103
114 A BILL TO BE ENTITLED
125 AN ACT
13- relating to notice of health benefit plan provider network status
14- provided by certain freestanding emergency medical care
15- facilities.
6+ relating to health care information provided by certain
7+ freestanding emergency medical care facilities.
168 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
179 SECTION 1. Section 241.252, Health and Safety Code, is
18- amended by amending Subsection (b) and adding Subsections (e) and
19- (f) to read as follows:
10+ amended by amending Subsection (b) and adding Subsection (b-1) to
11+ read as follows:
2012 (b) A facility described by Section 241.251 shall post
21- notice that:
22- (1) states:
23- (A) [(1) that] the facility is a freestanding
24- emergency medical care facility;
25- (B) [(2) that] the facility charges rates
26- comparable to a hospital emergency room and may charge a facility
27- fee;
28- (C) [(3) that] a facility or a physician
29- providing medical care at the facility may not be a participating
30- provider in the patient's health benefit plan provider network; and
31- (D) [(4) that] a physician providing medical
32- care at the facility may bill separately from the facility for the
33- medical care provided to a patient; and
34- (2) either:
35- (A) lists the health benefit plans in which the
36- facility is a participating provider in the health benefit plan's
13+ notice that states:
14+ (1) that the facility is a freestanding emergency
15+ medical care facility and not an urgent care center;
16+ (2) that the facility charges rates comparable to a
17+ hospital emergency room and may charge a facility fee;
18+ (3) [that a facility or a physician providing medical
19+ care at the facility may not be a participating provider in the
20+ patient's health benefit plan provider network; and
21+ [(4)] that a physician providing medical care at the
22+ facility may bill separately from the facility for the medical care
23+ provided to a patient;
24+ (4) any facility fee charged by the facility will be
25+ disclosed at the time of service to a patient upon request; and
26+ (5) either:
27+ (A) that the facility does not participate in a
3728 provider network; or
38- (B) states the facility is not a participating
39- provider in any health benefit plan provider network.
40- (e) Notwithstanding Subsection (c), a facility that is a
41- participating provider in one or more health benefit plan provider
42- networks complies with Subsection (b)(2) if the facility:
43- (1) provides notice on the facility's Internet website
44- listing the health benefit plans in which the facility is a
45- participating provider in the health benefit plan's provider
46- network; and
47- (2) provides to a patient written confirmation of
48- whether the facility is a participating provider in the patient's
49- health benefit plan's provider network.
50- (f) A facility described by Section 241.251 may not include
51- in any of the facility's signage or marketing materials the logo or
52- name of any insurer, health maintenance organization, health
53- benefit plan, or health benefit plan network in which the facility
54- does not participate.
29+ (B) that the facility participates in a provider
30+ network.
31+ (6) State and federal laws require health plans to
32+ cover emergency services at the in network level of benefits. An
33+ out-of-network provider can bill you for amounts in addition to the
34+ applicable copay, coinsurance and deductible amounts. Depending on
35+ your health benefit plan, you may be responsible for all charges in
36+ excess of your health plan's allowable amount for out-of-network
37+ providers.
5538 SECTION 2. Section 254.155, Health and Safety Code, is
56- amended by amending Subsection (a) and adding Subsections (d) and
57- (e) to read as follows:
58- (a) A facility shall post notice that:
59- (1) states:
60- (A) [(1) that] the facility is a freestanding
61- emergency medical care facility;
62- (B) [(2) that] the facility charges rates
63- comparable to a hospital emergency room and may charge a facility
64- fee;
65- (C) [(3) that] a facility or a physician
66- providing medical care at the facility may not be a participating
67- provider in the patient's health benefit plan provider network; and
68- (D) [(4) that] a physician providing medical
69- care at the facility may bill separately from the facility for the
70- medical care provided to a patient; and
71- (2) either:
72- (A) lists the health benefit plans in which the
73- facility is a participating provider in the health benefit plan's
39+ amended by amending Subsection (a) and adding Subsection (a-1) to
40+ read as follows:
41+ (a) A facility shall post notice that states:
42+ (1) that the facility is a freestanding emergency
43+ medical care facility and not an urgent care center;
44+ (2) that the facility charges rates comparable to a
45+ hospital emergency room and may charge a facility fee;
46+ (3) [that a facility or a physician providing medical
47+ care at the facility may not be a participating provider in the
48+ patient's health benefit plan provider network; and
49+ [(4)] that a physician providing medical care at the
50+ facility may bill separately from the facility for the medical care
51+ provided to a patient;
52+ (4) any facility fee charged by the facility will be
53+ disclosed at the time of service to a patient upon request; and
54+ (5) either:
55+ (A) that the facility does not participate in a
7456 provider network; or
75- (B) states the facility is not a participating
76- provider in any health benefit plan provider network.
77- (d) Notwithstanding Subsection (b), a facility that is a
78- participating provider in one or more health benefit plan provider
79- networks complies with Subsection (a)(2) if the facility:
80- (1) provides notice on the facility's Internet website
81- listing the health benefit plans in which the facility is a
82- participating provider in the health benefit plan's provider
83- network; and
84- (2) provides to a patient written confirmation of
85- whether the facility is a participating provider in the patient's
86- health benefit plan's provider network.
87- (e) A facility may not include in any of the facility's
88- signage or marketing materials the logo or name of any insurer,
89- health maintenance organization, health benefit plan, or health
90- benefit plan network in which the facility does not participate.
91- SECTION 3. This Act takes effect September 1, 2017.
92- * * * * *
57+ (B) that the facility participates in a provider
58+ network.
59+ (6) State and federal laws require health plans to
60+ cover emergency services at the in network level of benefits. An
61+ out-of-network provider can bill you for amounts in addition to the
62+ applicable copay, coinsurance and deductible amounts. Depending on
63+ your health benefit plan, you may be responsible for all charges in
64+ excess of your health plan's allowable amount for out-of-network
65+ providers.
66+ SECTION 3. Notwithstanding Sections 241.252 and 254.155,
67+ Health and Safety Code, as amended by this Act, a freestanding
68+ emergency medical care facility is not required to comply with
69+ those provisions until January 1, 2018.
70+ SECTION 4. This Act takes effect September 1, 2017.