Texas 2019 - 86th Regular

Texas House Bill HB2041 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 2041
	1	+	By: Oliverson, et al. (Senate Sponsor - Taylor) H.B. No. 2041
	2	+	(In the Senate - Received from the House May 2, 2019;
	3	+	May 7, 2019, read first time and referred to Committee on Business &
	4	+	Commerce; May 19, 2019, reported favorably by the following vote:
	5	+	Yeas 8, Nays 0; May 19, 2019, sent to printer.)
	6	+	Click here to see the committee vote
2	7
3	8
	9	+	A BILL TO BE ENTITLED
4	10		AN ACT
5	11		relating to the regulation of freestanding emergency medical care
6	12		facilities.
7	13		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	14		SECTION 1. Section 108.002(10), Health and Safety Code, is
9	15		amended to read as follows:
10	16		(10) "Health care facility" means:
11	17		(A) a hospital;
12	18		(B) an ambulatory surgical center licensed under
13	19		Chapter 243;
14	20		(C) a chemical dependency treatment facility
15	21		licensed under Chapter 464;
16	22		(D) a renal dialysis facility;
17	23		(E) a birthing center;
18	24		(F) a rural health clinic;
19	25		(G) a federally qualified health center as
20	26		defined by 42 U.S.C. Section 1396d(l)(2)(B); [or]
21	27		(H) a freestanding [free-standing] imaging
22	28		center; or
23	29		(I) a freestanding emergency medical care
24	30		facility, as defined by Section 254.001, including a freestanding
25	31		emergency medical care facility that is exempt from the licensing
26	32		requirements of Chapter 254 under Section 254.052(8).
27	33		SECTION 2. Section 241.202, Health and Safety Code, is
28	34		amended to read as follows:
29	35		Sec. 241.202. ADVERTISING. A facility described by Section
30	36		241.201:
31	37		(1) may not advertise or hold itself out as a medical
32	38		office, facility, or provider other than an emergency room if the
33	39		facility charges for its services the usual and customary rate
34	40		charged for the same service by a hospital emergency room in the
35	41		same region of the state or located in a region of the state with
36	42		comparable rates for emergency health care services; and
37	43		(2) must comply with the regulations in Section
38	44		254.157.
39	45		SECTION 3. Subchapter I, Chapter 241, Health and Safety
40	46		Code, is amended by adding Section 241.205 to read as follows:
41	47		Sec. 241.205. DISCLOSURE STATEMENT REQUIRED. A facility
42	48		described by Section 241.201 shall comply with Section 254.156.
43	49		SECTION 4. Section 254.104, Health and Safety Code, is
44	50		amended to read as follows:
45	51		Sec. 254.104. FREESTANDING EMERGENCY MEDICAL CARE FACILITY
46	52		LICENSING FUND. All fees and administrative penalties collected
47	53		under this chapter shall be deposited in the state treasury to the
48	54		credit of the freestanding emergency medical care facility
49	55		licensing fund and may be appropriated to the department only to
50	56		administer and enforce this chapter.
51	57		SECTION 5. Section 254.155, Health and Safety Code, is
52	58		amended by amending Subsections (a), (b), and (d) and adding
53	59		Subsection (e) to read as follows:
54	60		(a) A facility shall post notice that:
55	61		(1) states:
56	62		(A) the facility is a freestanding emergency
57	63		medical care facility;
58	64		(B) the facility charges rates comparable to a
59	65		hospital emergency room and may charge a facility fee;
60	66		(C) a facility or a physician providing medical
61	67		care at the facility may [not] be an out-of-network [a
62	68		participating] provider for [in] the patient's health benefit plan
63	69		provider network; and
64	70		(D) a physician providing medical care at the
65	71		facility may bill separately from the facility for the medical care
66	72		provided to a patient; and
67	73		(2) either:
68	74		(A) lists the health benefit plans in which the
69	75		facility is an in-network [a participating] provider in the health
70	76		benefit plan's provider network; or
71	77		(B) states the facility is an out-of-network [not
72	78		a participating] provider for all [in any] health benefit plans
73	79		[plan provider network].
74	80		(b) The notice required by this section must be posted
75	81		prominently and conspicuously:
76	82		(1) at the primary entrance to the facility;
77	83		(2) in each patient treatment room;
78	84		(3) at each location within the facility at which a
79	85		person pays for health care services; and
80	86		(4) on the home page of the facility's Internet website
81	87		or on a different page available through a hyperlink that is:
82	88		(A) entitled "Insurance Information"; and
83	89		(B) located prominently on the home page.
84	90		(d) Notwithstanding Subsection (b), a facility that is an
85	91		in-network [a participating] provider in one or more health benefit
86	92		plan provider networks complies with Subsection (a)(2) if the
87	93		facility:
88	94		(1) provides notice on the facility's Internet website
89	95		listing the health benefit plans in which the facility is an
90	96		in-network [a participating] provider in the health benefit plan's
91	97		provider network; and
92	98		(2) provides to a patient written confirmation of
93	99		whether the facility is an in-network [a participating] provider in
94	100		the patient's health benefit plan's provider network.
95	101		(e) A facility may not add to or alter the language of a
96	102		notice required by this section.
97	103		SECTION 6. Subchapter D, Chapter 254, Health and Safety
98	104		Code, is amended by adding Sections 254.156, 254.157, and 254.158
99	105		to read as follows:
100	106		Sec. 254.156. DISCLOSURE STATEMENT REQUIRED. (a) In
101	107		addition to the notice required under Section 254.155, a facility
102	108		shall provide to a patient or a patient's legally authorized
103	109		representative a written disclosure statement in accordance with
104	110		this section that:
105	111		(1) lists the facility's observation and facility fees
106	112		that may result from the patient's visit; and
107	113		(2) lists the health benefit plans in which the
108	114		facility is a network provider in the health benefit plan's
109	115		provider network or states that the facility is an out-of-network
110	116		provider for all health benefit plans.
111	117		(b) A facility shall provide the disclosure statement in
112	118		accordance with the standards prescribed by Section 254.153(a).
113	119		(c) The disclosure statement must be:
114	120		(1) printed in at least 16-point boldface type;
115	121		(2) in a contrasting color using a font that is easily
116	122		readable; and
117	123		(3) in English and Spanish.
118	124		(d) The disclosure statement:
119	125		(1) must include:
120	126		(A) the name and contact information of the
121	127		facility; and
122	128		(B) a place for the patient or the patient's
123	129		legally authorized representative and an employee of the facility
124	130		to sign and date the disclosure statement;
125	131		(2) may include information on the facility's
126	132		procedures for seeking reimbursement from the patient's health
127	133		benefit plan; and
128	134		(3) must, as applicable:
129	135		(A) state "This facility charges a facility fee
130	136		for medical treatment" and include:
131	137		(i) the facility's median facility fee;
132	138		(ii) a range of possible facility fees; and
133	139		(iii) the facility fees for each level of
134	140		care provided at the facility; and
135	141		(B) state "This facility charges an observation
136	142		fee for medical treatment" and include:
137	143		(i) the facility's median observation fee;
138	144		(ii) a range of possible observation fees;
139	145		and
140	146		(iii) the observation fees for each level
141	147		of care provided at the facility.
142	148		(e) A facility may include only the information described by
143	149		Subsection (d) in the required disclosure statement and may not
144	150		include any additional information in the statement. The facility
145	151		annually shall update the statement.
146	152		(f) A facility shall provide each patient with a physical
147	153		copy of the disclosure statement even if the patient refuses or is
148	154		unable to sign the statement. If a patient refuses or is unable to
149	155		sign the statement, as required by this section, the facility shall
150	156		indicate in the patient's file that the patient failed to sign.
151	157		(g) A facility shall retain a copy of a signed disclosure
152	158		statement provided under this section until the first anniversary
153	159		of the date on which the disclosure was signed.
154	160		(h) A facility is not required to provide notice to a
155	161		patient or a patient's legally authorized representative under this
156	162		section if the facility determines before providing emergency
157	163		health care services to the patient that the patient will not be
158	164		billed for the services.
159	165		(i) A facility complies with the requirements of
160	166		Subsections (a)(1) and (d)(3) if the facility posts on the
161	167		facility's Internet website in a manner that is easily accessible
162	168		and readable:
163	169		(1) the facility's standard charges, including the
164	170		fees described by those subsections; and
165	171		(2) updates to the standard charges at least annually
166	172		or more frequently as appropriate to reflect the facility's current
167	173		charges.
168		-	(j) A facility's failure to obtain the signed disclosure
169		-	statement required by this section from the patient or the
170		-	patient's legally authorized representative may not be a
171		-	determining factor in the adjudication of liability for health care
172		-	services provided to the patient at the facility.
173	174		Sec. 254.157. CERTAIN ADVERTISING PROHIBITED. (a) A
174	175		facility may not advertise or hold itself out as a network provider,
175	176		including by stating that the facility "takes" or "accepts" any
176	177		insurer, health maintenance organization, health benefit plan, or
177	178		health benefit plan network, unless the facility is a network
178	179		provider of a health benefit plan issuer.
179	180		(b) A facility may not post the name or logo of a health
180	181		benefit plan issuer in any signage or marketing materials if the
181	182		facility is an out-of-network provider for all of the issuer's
182	183		health benefit plans.
183	184		(c) A violation of this section is a false, misleading, or
184	185		deceptive act or practice under Subchapter E, Chapter 17, Business &
185	186		Commerce Code, and is actionable under that subchapter.
186	187		Sec. 254.158. REMOVAL OF SIGNS. A facility that closes or
187	188		for which a license issued under this chapter expires or is
188	189		suspended or revoked shall immediately remove or cause to be
189	190		removed any signs within view of the general public indicating that
190	191		the facility is in operation.
191	192		SECTION 7. Sections 254.203(a) and (b), Health and Safety
192	193		Code, are amended to read as follows:
193	194		(a) The department may petition a district court for a
194	195		temporary restraining order to restrain a continuing violation of
195	196		the standards or licensing requirements provided under this chapter
196	197		or of Section 254.158 if the department finds that the violation
197	198		creates an immediate threat to the health and safety of the patients
198	199		of a facility or of the public.
199	200		(b) A district court, on petition of the department and on a
200	201		finding by the court that a person is violating the standards or
201	202		licensing requirements provided under this chapter or is violating
202	203		Section 254.158, may by injunction:
203	204		(1) prohibit a person from continuing the [a]
204	205		violation [of the standards or licensing requirements provided
205	206		under this chapter];
206	207		(2) restrain or prevent the establishment or operation
207	208		of a facility without a license issued under this chapter; or
208	209		(3) grant any other injunctive relief warranted by the
209	210		facts.
210	211		SECTION 8. Sections 254.205(a) and (c), Health and Safety
211	212		Code, are amended to read as follows:
212	213		(a) The department may impose an administrative penalty on a
213	214		person licensed under this chapter who violates this chapter or a
214	215		rule or order adopted under this chapter. A penalty collected under
215	216		this section or Section 254.206 shall be deposited in the state
216	217		treasury to the credit of the freestanding emergency medical care
217	218		facility licensing [in the general revenue] fund described by
218	219		Section 254.104.
219	220		(c) The [amount of the] penalty may not exceed $1,000 for
220	221		each violation. Each[, and each] day of a continuing violation may
221	222		be considered [continues or occurs is] a separate violation for
222	223		purposes of imposing a penalty. [The total amount of the penalty
223	224		assessed for a violation continuing or occurring on separate days
224	225		under this subsection may not exceed $5,000.]
225	226		SECTION 9. Notwithstanding Section 108.002, Health and
226	227		Safety Code, as amended by this Act, the Department of State Health
227	228		Services is not required to collect data from a freestanding
228	229		emergency medical care facility under Chapter 108, Health and
229	230		Safety Code, unless money is available for that purpose.
230		-	SECTION 10. The Health and Human Services Commission and
231		-	the Department of State Health Services are required to implement a
232		-	provision of this Act only if the legislature appropriates money
233		-	specifically for that purpose. If the legislature does not
234		-	appropriate money specifically for that purpose, the commission and
235		-	department may, but are not required to, implement a provision of
236		-	this Act using other appropriations available for that purpose.
237		-	SECTION 11. This Act takes effect September 1, 2019.
238		-	______________________________ ______________________________
239		-	President of the Senate Speaker of the House
240		-	I certify that H.B. No. 2041 was passed by the House on May 2,
241		-	2019, by the following vote: Yeas 135, Nays 4, 2 present, not
242		-	voting; and that the House concurred in Senate amendments to H.B.
243		-	No. 2041 on May 24, 2019, by the following vote: Yeas 141, Nays 2,
244		-	2 present, not voting.
245		-	______________________________
246		-	Chief Clerk of the House
247		-	I certify that H.B. No. 2041 was passed by the Senate, with
248		-	amendments, on May 22, 2019, by the following vote: Yeas 31, Nays
249		-	0.
250		-	______________________________
251		-	Secretary of the Senate
252		-	APPROVED: __________________
253		-	Date
254		-	__________________
255		-	Governor
	231	+	SECTION 10. This Act takes effect September 1, 2019.
	232	+	* * * * *