Texas 2025 - 89th Regular

Texas Senate Bill SB1219 Compare Versions

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

Old	New	Differences
1	1	89R2858 MCF-F
2	2	By: Hughes S.B. No. 1219
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to price estimates and billing requirements for certain
10	10	health care facilities.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 324.001, Health and Safety Code, is
13	13	amended by adding Subdivision (5-a) to read as follows:
14	14	(5-a) "Estimate" means a written statement outlining
15	15	the total amount a facility will accept as payment in full,
16	16	inclusive of all payment sources, for a nonemergency elective
17	17	medical service or procedure.
18	18	SECTION 2. Section 324.101, Health and Safety Code, is
19	19	amended by amending Subsections (d) and (g) and adding Subsections
20	20	(d-1) and (d-2) to read as follows:
21	21	(d) A consumer who presents to a [The] facility a valid
22	22	medical order [shall provide an estimate of the facility's charges]
23	23	for any elective inpatient admission or nonemergency outpatient
24	24	surgical procedure or other service is entitled to receive on
25	25	request and before the scheduling of the admission, [or] procedure,
26	26	or service an estimate from the facility. Not later than 24 hours
27	27	after receiving a request for an estimate under this subsection,
28	28	the facility shall provide the [The] estimate to the requesting
29	29	consumer in person, by e-mail, or through an online patient portal,
30	30	as chosen by the consumer [must be provided not later than the 10th
31	31	business day after the date on which the estimate is requested].
32	32	[The facility must advise the consumer that:
33	33	[(1) the request for an estimate of charges may result
34	34	in a delay in the scheduling and provision of the inpatient
35	35	admission, outpatient surgical procedure, or other service;
36	36	[(2) the actual charges for an inpatient admission,
37	37	outpatient surgical procedure, or other service will vary based on
38	38	the person's medical condition and other factors associated with
39	39	performance of the procedure or service;
40	40	[(3) the actual charges for an inpatient admission,
41	41	outpatient surgical procedure, or other service may differ from the
42	42	amount to be paid by the consumer or the consumer's third-party
43	43	payor;
44	44	[(4) the consumer may be personally liable for payment
45	45	for the inpatient admission, outpatient surgical procedure, or
46	46	other service depending on the consumer's health benefit plan
47	47	coverage; and
48	48	[(5) the consumer should contact the consumer's health
49	49	benefit plan for accurate information regarding the plan structure,
50	50	benefit coverage, deductibles, copayments, coinsurance, and other
51	51	plan provisions that may impact the consumer's liability for
52	52	payment for the inpatient admission, outpatient surgical
53	53	procedure, or other service.]
54	54	(d-1) A facility's final billed charges may not exceed the
55	55	amount specified in the estimate provided under Subsection (d) by
56	56	more than five percent unless the additional charges are:
57	57	(1) related to complications arising during the
58	58	procedure or service and not reasonably avoidable in provision of
59	59	the procedure or service by the medical provider while exercising
60	60	reasonable medical judgment; or
61	61	(2) as a result of a change of diagnosis not
62	62	discoverable before the procedure or service and documented in the
63	63	patient's chart.
64	64	(d-2) If the final billed charges exceed the amount
65	65	specified in an estimate provided under Subsection (d) by more than
66	66	five percent, the facility must provide to the patient a written
67	67	statement describing:
68	68	(1) the difference in the final billed amount and the
69	69	estimate amount; and
70	70	(2) a plain-language explanation describing the
71	71	complications or change of diagnosis that resulted in the
72	72	difference.
73	73	(g) A facility that violates [in violation of] this section:
74	74	(1) may not:
75	75	(A) collect or take any collection action against
76	76	a consumer or other financially responsible party;
77	77	(B) report the consumer to a credit bureau; or
78	78	(C) pursue an action against the consumer; and
79	79	(2) is subject to enforcement action by the
80	80	appropriate licensing agency.
81	81	SECTION 3. Subchapter B, Chapter 324, Health and Safety
82	82	Code, is repealed.
83	83	SECTION 4. The changes in law made to Chapter 324, Health
84	84	and Safety Code, apply only to a request for an estimate made on or
85	85	after the effective date of this Act. A request for an estimate
86	86	made before the effective date of this Act is governed by the law in
87	87	effect at the time the request was made, and the former law is
88	88	continued in effect for that purpose.
89	89	SECTION 5. This Act takes effect September 1, 2025.