Texas 2025 - 89th Regular

Texas House Bill HB1314 Compare Versions

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

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1	1	By: Hickland H.B. No. 1314
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6	6	A BILL TO BE ENTITLED
7	7	AN ACT
8	8	relating to price estimates and billing requirements for certain
9	9	health care facilities.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 324.001, Health and Safety Code, is
12	12	amended by adding Subdivision (5-a) to read as follows:
13	13	(5-a) "Estimate" means a written statement outlining a
14	14	consumer's total expected billed charges for a nonemergency
15	15	elective medical service or procedure.
16	16	SECTION 2. Section 324.101, Health and Safety Code, is
17	17	amended by amending Subsections (d) and (g) and adding Subsection
18	18	(d-1) to read as follows:
19	19	(d) A consumer who presents to a [The] facility a valid
20	20	medical order [shall provide an estimate of the facility's charges]
21	21	for any elective inpatient admission or nonemergency outpatient
22	22	surgical procedure or other service is entitled to receive on
23	23	request and before the scheduling of the admission, [or] procedure,
24	24	or service an estimate of the facility's charges for the admission,
25	25	procedure, or service. Not later than 24 hours after receiving a
26	26	request for an estimate under this subsection, the facility shall
27	27	provide the [The] estimate to the requesting consumer by e-mail
28	28	[must be provided not later than the 10th business day after the
29	29	date on which the estimate is requested]. The facility must advise
30	30	the consumer that:
31	31	(1) the request for an estimate of billed charges may
32	32	result in a delay in the scheduling and provision of the inpatient
33	33	admission, outpatient surgical procedure, or other service;
34	34	(2) the actual charges for an inpatient admission,
35	35	outpatient surgical procedure, or other service will vary based on
36	36	the person's medical condition and other factors associated with
37	37	performance of the procedure or service;
38	38	(3) the actual charges for an inpatient admission,
39	39	outpatient surgical procedure, or other service may differ from the
40	40	amount to be paid by the consumer or the consumer's third-party
41	41	payor;
42	42	(4) the consumer may be personally liable for payment
43	43	for the inpatient admission, outpatient surgical procedure, or
44	44	other service depending on the consumer's health benefit plan
45	45	coverage; and
46	46	(5) the consumer should contact the consumer's health
47	47	benefit plan for accurate information regarding the plan structure,
48	48	benefit coverage, deductibles, copayments, coinsurance, and other
49	49	plan provisions that may impact the consumer's liability for
50	50	payment for the inpatient admission, outpatient surgical
51	51	procedure, or other service.
52	52	(d-1) A facility's final billed charges may not exceed the
53	53	amount specified in an estimate by more than five percent unless the
54	54	additional charges are related to complications that arose during
55	55	the procedure or service or as a result of a change of diagnosis
56	56	that is documented in the patient's chart. If the final billed
57	57	charges exceed the amount specified in an estimate by more than five
58	58	percent, the facility shall provide to the patient a written
59	59	statement describing:
60	60	(1) the difference in the billed charge amount and the
61	61	estimate amount; and
62	62	(2) the complications or change of diagnosis that
63	63	resulted in the difference.
64	64	(g) A facility that violates [in violation of] this section:
65	65	(1) may not:
66	66	(A) collect or take any collection action against
67	67	a consumer;
68	68	(B) report the consumer to a credit bureau; or
69	69	(C) pursue an action against the consumer; and
70	70	(2) is subject to an enforcement action by the
71	71	appropriate licensing agency.
72	72	SECTION 3. Subchapter B, Chapter 324, Health and Safety
73	73	Code, is repealed.
74	74	SECTION 4. The changes in law made to Chapter 324, Health
75	75	and Safety Code, apply only to a request for an estimate made on or
76	76	after the effective date of this Act. A request for an estimate
77	77	made before the effective date of this Act is governed by the law in
78	78	effect at the time the request was made, and the former law is
79	79	continued in effect for that purpose.
80	80	SECTION 5. This Act takes effect September 1, 2025.