By: Martinez Fischer H.B. No. 4444
A BILL TO BE ENTITLED
AN ACT
relating to consumer protections against surprise billing.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter E, Chapter 17, Business & Commerce
Code, is amended by adding Section 17.464 to read as follows:
Sec. 17.464. SURPRISE BILLING. (a) In this section:
(1) "Emergency care" has the meaning assigned by
Section 1301.155.
(2) "Emergency care provider" means a physician,
health care practitioner, facility, or other health care provider
who provides emergency care.
(3) "Facility" has the meaning assigned by Section
324.001, Health and Safety Code.
(4) "Facility-based provider" means a physician or
health care provider who provides health care services to patients
of a health care facility.
(5) "Health care practitioner" means an individual who
is licensed to provide health care services.
(6) "Participating provider" means a physician or
health care provider who has contracted with an eligible plan
administrator to provide services to enrollees.
(7) "Surprise bill" means a bill received by an
insured or enrollee for amounts in addition to the applicable
copayment, coinsurance, and deductible:
(A) for services furnished by an out-of-network
facility-based provider who performed the service at a facility
that is an in-network provider; or
(B) for emergency care services furnished by an
out-of-network provider.
(b) For purposes of Section 17.46(a), the term "false,
misleading, or deceptive acts or practices" includes a
facility-based provider that bills an enrollee receiving health
care services described by Subsection (a)(7), except for the
enrollee's responsibility under the enrollee's health plan,
including an applicable copayment, coinsurance, or deductible.
(c) The consumer protection division may not bring an action
under Section 17.47 for an act or practice described by Subsection
(b) if the bill sent to the enrollee is less than five hundred
dollars.
(d) In an action brought under Section 17.47 to enforce this
section, the consumer protection division may request, and the
trier of fact may award the recovery of:
(1) reasonable attorney's fees and court costs; and
(2) the reasonable expenses incurred by the division
in obtaining any remedy available under Section 17.47, including
the cost of investigation, witness fees, and deposition expenses.
SECTION 2. This Act takes effect September 1, 2019.