Texas 2021 - 87th Regular

Texas House Bill HB1369 Compare Versions

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

Old	New	Differences
1	1	87R1705 SCL-D
2	2	By: Jetton H.B. No. 1369
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to regulation of health care cost-sharing organizations.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. The heading to Subtitle K, Title 8, Insurance
10	10	Code, is amended to read as follows:
11	11	SUBTITLE K. HEALTH CARE COST SHARING [MINISTRIES]
12	12	SECTION 2. Subtitle K, Title 8, Insurance Code, is amended
13	13	by adding Chapter 1682 to read as follows:
14	14	CHAPTER 1682. HEALTH CARE COST-SHARING ORGANIZATIONS
15	15	SUBCHAPTER A. GENERAL PROVISIONS
16	16	Sec. 1682.0001. DEFINITIONS. In this chapter:
17	17	(1) "Health care cost-sharing organization" means an
18	18	entity that facilitates the sharing of health care expenses among
19	19	the entity's participants. The term does not include a health
20	20	benefit plan issuer or a health care sharing ministry described by
21	21	Section 1681.001.
22	22	(2) "Participant" means an individual enrolled in a
23	23	health care cost-sharing organization to voluntarily share health
24	24	care expenses with other individuals enrolled in the organization.
25	25	Sec. 1682.0002. EXEMPTION. Notwithstanding any other
26	26	provision of this code, a health care cost-sharing organization
27	27	that acts in accordance with this chapter is not considered to be
28	28	engaging in the business of insurance.
29	29	Sec. 1682.0003. CONSTRUCTION OF CHAPTER. This chapter may
30	30	not be construed to assign responsibility for a person's health
31	31	care expenses to any other person.
32	32	SUBCHAPTER B. REGULATION OF HEALTH CARE COST-SHARING ORGANIZATIONS
33	33	Sec. 1682.0051. HEALTH CARE COST SHARING. (a) A health care
34	34	cost-sharing organization shall facilitate health care cost
35	35	sharing among its participants by matching participants with health
36	36	care bills to participants with the ability to provide financial
37	37	assistance in accordance with the criteria established by the
38	38	organization.
39	39	(b) In facilitating health care cost sharing, a health care
40	40	cost-sharing organization:
41	41	(1) shall collect resources from participants to
42	42	provide payments for a participant's health care bills through the
43	43	direct contributions from one participant to another without the
44	44	pooling of accounts; and
45	45	(2) may not have a financial interest in a
46	46	participant's decision on whether to share money.
47	47	Sec. 1682.0052. COMMUNITY MAINTENANCE. A health care
48	48	cost-sharing organization may suggest an amount that participants
49	49	may voluntarily contribute to community maintenance. The
50	50	organization may not require a participant to make a contribution
51	51	or assume a risk for the community maintenance.
52	52	Sec. 1682.0053. REQUIRED DISCLOSURES. (a) A health care
53	53	cost-sharing organization shall provide the following written
54	54	disclosure to prospective participants and annually to
55	55	participants:
56	56	"Health care cost-sharing organizations facilitate the
57	57	sharing of health care expenses but are not insurance companies.
58	58	Neither their guidelines nor their plans of operation are an
59	59	insurance policy. Whether anyone chooses to assist you with your
60	60	health care bills will be totally voluntary because no other
61	61	participant will be compelled by law to contribute toward your
62	62	health care bills.
63	63	"As such, participation in the cost-sharing coverage or a
64	64	subscription to any of its documents should never be considered to
65	65	be or treated like insurance. Regardless of whether you receive any
66	66	payment for health care expenses or whether this organization
67	67	continues to operate, you are always personally responsible for the
68	68	payment of your own health care bills. Complaints concerning any
69	69	health care cost-sharing organization may be reported to the office
70	70	of the Texas attorney general."
71	71	(b) A health care cost-sharing organization shall provide a
72	72	written disclosure of all administrative fees and costs to
73	73	prospective participants and annually to participants.
74	74	Sec. 1682.0054. MONTHLY STATEMENT. A health care
75	75	cost-sharing organization shall provide a written monthly
76	76	statement to all participants that lists:
77	77	(1) the total dollar amount of qualified needs
78	78	submitted to the organization; and
79	79	(2) the amount actually published or assigned to
80	80	participants for their contribution.
81	81	Sec. 1682.0055. PARTICIPANT CARD. A health care
82	82	cost-sharing organization shall ensure that a card issued to a
83	83	participant for the purpose of presentation to a health care
84	84	provider clearly indicates that the participant is part of a health
85	85	care cost-sharing organization that is not engaging in the business
86	86	of insurance.
87	87	Sec. 1682.0056. DISCOUNT HEALTH CARE PROGRAM PROHIBITED. A
88	88	health care cost-sharing organization may not operate a discount
89	89	health care program as defined by Section 7001.001.
90	90	Sec. 1682.0057. COMPLAINT; INJUNCTION. (a) A person who
91	91	reasonably believes that a health care cost-sharing organization is
92	92	not complying with this chapter may file a written complaint with
93	93	the attorney general.
94	94	(b) The attorney general may investigate a complaint
95	95	received under Subsection (a). If the attorney general determines
96	96	that a violation has occurred, the attorney general may bring a
97	97	civil action in the name of the state for an injunction against a
98	98	health care cost-sharing organization that is violating this
99	99	chapter.
100	100	SECTION 3. This Act takes effect September 1, 2021.