Texas 2023 - 88th Regular

Texas House Bill HB3218 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R12345 LRM-F
2	2	By: Klick H.B. No. 3218
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to price estimates and billing requirements for certain
8	8	health care facilities.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 324.001, Health and Safety Code, is
11	11	amended by adding Subdivision (5-a) to read as follows:
12	12	(5-a) "Estimate" means a written statement outlining a
13	13	consumer's total expected billed charges for a nonemergency
14	14	elective medical service or procedure.
15	15	SECTION 2. Section 324.101, Health and Safety Code, is
16	16	amended by amending Subsections (d) and (g) and adding Subsection
17	17	(d-1) to read as follows:
18	18	(d) A consumer who presents to a [The] facility a valid
19	19	medical order [shall provide an estimate of the facility's charges]
20	20	for any elective inpatient admission or nonemergency outpatient
21	21	surgical procedure or other service is entitled to receive on
22	22	request and before the scheduling of the admission, [or] procedure,
23	23	or service an estimate of the facility's charges for the admission,
24	24	procedure, or service. Not later than 24 hours after receiving a
25	25	request for an estimate under this subsection, the facility shall
26	26	provide the [The] estimate to the requesting consumer by e-mail
27	27	[must be provided not later than the 10th business day after the
28	28	date on which the estimate is requested]. The facility must advise
29	29	the consumer that:
30	30	(1) the request for an estimate of billed charges may
31	31	result in a delay in the scheduling and provision of the inpatient
32	32	admission, outpatient surgical procedure, or other service;
33	33	(2) the actual charges for an inpatient admission,
34	34	outpatient surgical procedure, or other service will vary based on
35	35	the person's medical condition and other factors associated with
36	36	performance of the procedure or service;
37	37	(3) the actual charges for an inpatient admission,
38	38	outpatient surgical procedure, or other service may differ from the
39	39	amount to be paid by the consumer or the consumer's third-party
40	40	payor;
41	41	(4) the consumer may be personally liable for payment
42	42	for the inpatient admission, outpatient surgical procedure, or
43	43	other service depending on the consumer's health benefit plan
44	44	coverage; and
45	45	(5) the consumer should contact the consumer's health
46	46	benefit plan for accurate information regarding the plan structure,
47	47	benefit coverage, deductibles, copayments, coinsurance, and other
48	48	plan provisions that may impact the consumer's liability for
49	49	payment for the inpatient admission, outpatient surgical
50	50	procedure, or other service.
51	51	(d-1) A facility's final billed charges may not exceed the
52	52	amount specified in an estimate by more than five percent unless the
53	53	additional charges are related to complications that arose during
54	54	the procedure or service or as a result of a change of diagnosis
55	55	that is documented in the patient's chart. If the final billed
56	56	charges exceed the amount specified in an estimate by more than five
57	57	percent, the facility shall provide to the patient a written
58	58	statement describing:
59	59	(1) the difference in the billed charge amount and the
60	60	estimate amount; and
61	61	(2) the complications or change of diagnosis that
62	62	resulted in the difference.
63	63	(g) A facility that violates [in violation of] this section:
64	64	(1) may not:
65	65	(A) collect or take any collection action against
66	66	a consumer;
67	67	(B) report the consumer to a credit bureau; or
68	68	(C) pursue an action against the consumer; and
69	69	(2) is subject to an enforcement action by the
70	70	appropriate licensing agency.
71	71	SECTION 3. Subchapter B, Chapter 324, Health and Safety
72	72	Code, is repealed.
73	73	SECTION 4. The changes in law made to Chapter 324, Health
74	74	and Safety Code, apply only to a request for an estimate made on or
75	75	after the effective date of this Act. A request for an estimate
76	76	made before the effective date of this Act is governed by the law in
77	77	effect at the time the request was made, and the former law is
78	78	continued in effect for that purpose.
79	79	SECTION 5. This Act takes effect September 1, 2023.