Texas 2019 - 86th Regular

Texas Senate Bill SB2415 Compare Versions

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

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1	1	By: Taylor S.B. No. 2415
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to the regulation of freestanding emergency medical care
7	7	facilities.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 108.002(10), Health and Safety Code, is
10	10	amended to read as follows:
11	11	(10) "Health care facility" means:
12	12	(A) a hospital;
13	13	(B) an ambulatory surgical center licensed under
14	14	Chapter 243;
15	15	(C) a chemical dependency treatment facility
16	16	licensed under Chapter 464;
17	17	(D) a renal dialysis facility;
18	18	(E) a birthing center;
19	19	(F) a rural health clinic;
20	20	(G) a federally qualified health center as
21	21	defined by 42 U.S.C. Section 1396d(l)(2)(B); [or]
22	22	(H) a freestanding [free-standing] imaging
23	23	center; or
24	24	(I) a freestanding emergency medical care
25	25	facility licensed under Chapter 254.
26	26	SECTION 2. Section 241.252, Health and Safety Code, is
27	27	amended by amending Subsections (b), (c), and (e) and adding
28	28	Subsection (f) to read as follows:
29	29	Sec. 241.252. NOTICE OF FEES. (a) In this section,
30	30	"provider network" has the meaning assigned by Section 1456.001,
31	31	Insurance Code.
32	32	(b) A facility described by Section 241.251 shall post
33	33	notice that:
34	34	(1) states:
35	35	(A) the facility is a freestanding emergency
36	36	medical care facility;
37	37	(B) the facility charges rates comparable to a
38	38	hospital emergency room and may charge a facility fee;
39	39	(C) a facility or a physician providing medical
40	40	care at the facility may not be an out-of-network [a participating]
41	41	provider for [in] the patient's health benefit plan provider
42	42	network; and
43	43	(D) a physician providing medical care at the
44	44	facility may bill separately from the facility for the medical care
45	45	provided to a patient; and
46	46	(2) either:
47	47	(A) lists the health benefit plans in which the
48	48	facility is a network participating provider in the health benefit
49	49	plan's provider network; or
50	50	(B) states the facility is an out-of-network [not
51	51	a participating]provider for all [in any] health benefit plans
52	52	[plan provider network].
53	53	(c) The notice required by this section must be posted
54	54	prominently and conspicuously:
55	55	(1) at the primary entrance to the facility;
56	56	(2) in each patient treatment room;
57	57	(3) at each location within the facility at which a
58	58	person pays for health care services; and
59	59	(4) on the home page of the facility's Internet website
60	60	or on a different page available through a hyperlink hat is:
61	61	(A) entitled "Insurance Information"; and
62	62	(B) located prominently on the home page.
63	63	(e) Notwithstanding Subsection (c), a facility that is a
64	64	network [participating] provider in one or more health benefit plan
65	65	provider networks complies with Subsection (b)(2) if the facility:
66	66	(1) provides notice on the facility's Internet website
67	67	listing the health benefit plans in which the facility is a network
68	68	[participating] provider in the health benefit plan's provider
69	69	network; and
70	70	(2) provides to a patient written confirmation of
71	71	whether the facility is a network [participating] provider in the
72	72	patient's health benefit plan's provider network.
73	73	(f) A facility may not add to or alter the language of a
74	74	notice required by this section.
75	75	SECTION 3. Subchapter J, Chapter 241, Health and Safety
76	76	Code, is amended by adding Sections 241.253 and 241.254 to read as
77	77	follows:
78	78	Sec. 241.253 DISCLOSURE STATEMENT REQUIRED. (a) In
79	79	addition to the notice required under Section 241.252, a facility
80	80	shall provide to a patient or a patient's legally authorized
81	81	representative a written disclosure statement in accordance with
82	82	this section that:
83	83	(1) lists the facility's observation and facility fees
84	84	that may result from the patient's visit; and
85	85	(2) lists the health benefit plans in which the
86	86	facility is a network provider in the health benefit plan's
87	87	provider network or states that the facility is an out-of-network
88	88	provider for all health benefit plans.
89	89	(b) A facility shall provide the disclosure statement
90	90	before providing health care services to the patient unless the
91	91	patient's medical condition requires immediate medical
92	92	intervention. If the patient's medical condition requires
93	93	immediate medical intervention, the facility shall provide the
94	94	disclosure statement as soon as practicable.
95	95	(c) The disclosure statement must be:
96	96	(1) printed in at least 16-point boldface type;
97	97	(2) in a contrasting color using a font that is easily
98	98	readable; and
99	99	(3) in English and Spanish.
100	100	(d) The disclosure statement:
101	101	(1) must include:
102	102	(A) the name and contact information of the
103	103	facility; and
104	104	(B) a place for the patient or the patient's
105	105	legally authorized representative and an employee of the facility
106	106	to sign and date the disclosure statement;
107	107	(2) may include information on the facility's
108	108	procedures for seeking reimbursement from the patient's health
109	109	benefit plan; and
110	110	(3) must state, as applicable:
111	111	"This facility charges a facility fee for medical treatment.
112	112	The average facility fee for patient treatment is $____."
113	113	"This facility charges an observation fee for medical
114	114	treatment. The average observation fee for patient treatment is
115	115	$____."
116	116	(e) A facility may include only the information described by
117	117	Subsection (d) in the required disclosure statement and may not
118	118	include any additional information in the statement. The facility
119	119	annually shall update the statement.
120	120	(f) A facility shall provide each patient with a physical
121	121	copy of the disclosure statement even if the patient refuses or is
122	122	unable to sign the statement. If a patient refuses or is unable to
123	123	sign the statement, as required by this section, the facility shall
124	124	indicate in the patient's file that the patient failed to sign.
125	125	(g) A facility shall retain a copy of a signed disclosure
126	126	statement provided under this section until the first anniversary
127	127	of the date on which the disclosure was signed.
128	128	Sec. 241.254 CERTAIN ADVERTISING PROHIBITED. (a) A
129	129	facility may not advertise or hold itself out as a network provider,
130	130	including by stating that the facility "takes" or "accepts" any
131	131	insurer, health maintenance organization, health benefit plan, or
132	132	health benefit plan network, unless the facility is a network
133	133	provider of a health benefit plan issuer.
134	134	(b) A facility may not post the name or logo of a health
135	135	benefit plan issuer in any signage or marketing materials if the
136	136	facility is an out-of-network provider for any of the issuer's
137	137	health benefit plans.
138	138	(c) A violation of this section is a false, misleading, or
139	139	deceptive act or practice under Subchapter E, Chapter 17, Business &
140	140	Commerce Code, and is actionable under that subchapter.
141	141	SECTION 4. Section 254.104, Health and Safety Code, is
142	142	amended to read as follows:
143	143	Sec. 254.104. FREESTANDING EMERGENCY MEDICAL CARE FACILITY
144	144	LICENSING FUND. All fees and administrative penalties collected
145	145	under this chapter shall be deposited in the state treasury to the
146	146	credit of the freestanding emergency medical care facility
147	147	licensing fund and may be appropriated to the department only to
148	148	administer and enforce this chapter.
149	149	SECTION 5. Section 254.155, Health and Safety Code, is
150	150	amended by amending Subsections (a), (b), and (d) and adding
151	151	Subsection (e) to read as follows:
152	152	(a) A facility shall post notice that:
153	153	(1) states:
154	154	(A) the facility is a freestanding emergency
155	155	medical care facility;
156	156	(B) the facility charges rates comparable to a
157	157	hospital emergency room and may charge a facility fee;
158	158	(C) a facility or a physician providing medical
159	159	care at the facility may [not] be an out-of-network [a
160	160	participating] provider for [in] the patient's health benefit plan
161	161	provider network; and
162	162	(D) a physician providing medical care at the
163	163	facility may bill separately from the facility for the medical care
164	164	provided to a patient; and
165	165	(2) either:
166	166	(A) lists the health benefit plans in which the
167	167	facility is a network [participating] provider in the health
168	168	benefit plan's provider network; or
169	169	(B) states the facility is an out-of-network [not
170	170	a participating] provider for all [in any] health benefit plans
171	171	[plan provider network].
172	172	(b) The notice required by this section must be posted
173	173	prominently and conspicuously:
174	174	(1) at the primary entrance to the facility;
175	175	(2) in each patient treatment room;
176	176	(3) at each location within the facility at which a
177	177	person pays for health care services; and
178	178	(4) on the home page of the facility's Internet website
179	179	or on a different page available through a hyperlink that is:
180	180	(A) entitled "Insurance Information"; and
181	181	(B) located prominently on the home page.
182	182	(d) Notwithstanding Subsection (b), a facility that is a
183	183	network [participating] provider in one or more health benefit plan
184	184	provider networks complies with Subsection (a)(2) if the facility:
185	185	(1) provides notice on the facility's Internet website
186	186	listing the health benefit plans in which the facility is a network
187	187	[participating] provider in the health benefit plan's provider
188	188	network; and
189	189	(2) provides to a patient written confirmation of
190	190	whether the facility is a network [participating] provider in the
191	191	patient's health benefit plan's provider network.
192	192	(e) A facility may not add to or alter the language of a
193	193	notice required by this section.
194	194	SECTION 6. Subchapter D, Chapter 254, Health and Safety
195	195	Code, is amended by adding Sections 254.156 and 254.157 to read as
196	196	follows:
197	197	Sec. 254.156. DISCLOSURE STATEMENT REQUIRED. (a) In
198	198	addition to the notice required under Section 254.155, a facility
199	199	shall provide to a patient or a patient's legally authorized
200	200	representative a written disclosure statement in accordance with
201	201	this section that:
202	202	(1) lists the facility's observation and facility fees
203	203	that may result from the patient's visit; and
204	204	(2) lists the health benefit plans in which the
205	205	facility is a network provider in the health benefit plan's
206	206	provider network or states that the facility is an out-of-network
207	207	provider for all health benefit plans.
208	208	(b) A facility shall provide the disclosure statement
209	209	before providing health care services to the patient unless the
210	210	patient's medical condition requires immediate medical
211	211	intervention. If the patient's medical condition requires
212	212	immediate medical intervention, the facility shall provide the
213	213	disclosure statement as soon as practicable.
214	214	(c) The disclosure statement must be:
215	215	(1) printed in at least 16-point boldface type;
216	216	(2) in a contrasting color using a font that is easily
217	217	readable; and
218	218	(3) in English and Spanish.
219	219	(d) The disclosure statement:
220	220	(1) must include:
221	221	(A) the name and contact information of the
222	222	facility; and
223	223	(B) a place for the patient or the patient's
224	224	legally authorized representative and an employee of the facility
225	225	to sign and date the disclosure statement;
226	226	(2) may include information on the facility's
227	227	procedures for seeking reimbursement from the patient's health
228	228	benefit plan; and
229	229	(3) must state, as applicable:
230	230	"This facility charges a facility fee for medical treatment.
231	231	The average facility fee for patient treatment is $____."
232	232	"This facility charges an observation fee for medical
233	233	treatment. The average observation fee for patient treatment is
234	234	$____."
235	235	(e) A facility may include only the information described by
236	236	Subsection (d) in the required disclosure statement and may not
237	237	include any additional information in the statement. The facility
238	238	annually shall update the statement.
239	239	(f) A facility shall provide each patient with a physical
240	240	copy of the disclosure statement even if the patient refuses or is
241	241	unable to sign the statement. If a patient refuses or is unable to
242	242	sign the statement, as required by this section, the facility shall
243	243	indicate in the patient's file that the patient failed to sign.
244	244	(g) A facility shall retain a copy of a signed disclosure
245	245	statement provided under this section until the first anniversary
246	246	of the date on which the disclosure was signed.
247	247	Sec. 254.157. CERTAIN ADVERTISING PROHIBITED. (a) A
248	248	facility may not advertise or hold itself out as a network provider,
249	249	including by stating that the facility "takes" or "accepts" any
250	250	insurer, health maintenance organization, health benefit plan, or
251	251	health benefit plan network, unless the facility is a network
252	252	provider of a health benefit plan issuer.
253	253	(b) A facility may not post the name or logo of a health
254	254	benefit plan issuer in any signage or marketing materials if the
255	255	facility is an out-of-network provider for any of the issuer's
256	256	health benefit plans.
257	257	(c) A violation of this section is a false, misleading, or
258	258	deceptive act or practice under Subchapter E, Chapter 17, Business &
259	259	Commerce Code, and is actionable under that subchapter.
260	260	SECTION 7. Sections 254.205(a) and (c), Health and Safety
261	261	Code, are amended to read as follows:
262	262	(a) The department may impose an administrative penalty on a
263	263	person licensed under this chapter who violates this chapter or a
264	264	rule or order adopted under this chapter. A penalty collected under
265	265	this section or Section 254.206 shall be deposited in the state
266	266	treasury to the credit of the freestanding emergency medical care
267	267	facility licensing [in the general revenue] fund described by
268	268	Section 254.104.
269	269	(c) The [amount of the] penalty [may not exceed $1,000] for
270	270	each violation may be in an amount not to exceed the maximum amount
271	271	provided by this subsection, and each day a violation continues or
272	272	occurs is a separate violation for purposes of imposing the [a]
273	273	penalty. The total amount of the penalty assessed for a violation
274	274	continuing or occurring on separate days under this subsection may
275	275	not exceed $25,000 [$5,000].
276	276	SECTION 8. This Act takes effect September 1, 2019.