By: Zaffirini, Hancock S.B. No. 916
A BILL TO BE ENTITLED
AN ACT
relating to consumer protections against certain medical and health
care billing by emergency medical services providers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 773.061, Health and Safety Code, is
amended by adding Subsection (a-1) to read as follows:
(a-1) In addition to other permissible actions or penalties
and regardless of whether an emergency medical services provider is
directly operated by a governmental entity, the department may
revoke, suspend, or refuse to renew a license or certificate of the
provider if the department confirms that the provider has:
(1) intentionally submitted incorrect information
required under Section 38.006, Insurance Code; or
(2) engaged in a pattern of violations of Section
1271.159, 1275.054, 1301.166, 1551.231, 1575.174, or 1579.112,
Insurance Code.
SECTION 2. Section 38.006(b), Insurance Code, is amended to
read as follows:
(b) This section expires September 1, 2027 [2025].
SECTION 3. Sections 1271.159(c) and (g), Insurance Code,
are amended to read as follows:
(c) A political subdivision may annually [health
maintenance organization shall] adjust a rate submitted under
Section 38.006 [payment required by Subsection (b)(1) each plan
year] by not more than [increasing the payment by] the lesser of:
(1) the Medicare Ambulance Inflation Factor; [Index]
or
(2) 10 percent of the provider's previous calendar
year rates.
(g) This section expires September 1, 2027 [2025].
SECTION 4. Sections 1275.054(c) and (f), Insurance Code,
are amended to read as follows:
(c) A political subdivision may annually [The administrator
shall] adjust a rate submitted under Section 38.006 [payment
required by Subsection (b)(1) each plan year] by not more than
[increasing the payment by] the lesser of:
(1) the Medicare Ambulance Inflation Factor; [Index]
or
(2) 10 percent of the provider's previous calendar
year rates.
(f) This section expires September 1, 2027 [2025].
SECTION 5. Sections 1301.166(c) and (g), Insurance Code,
are amended to read as follows:
(c) A political subdivision may annually [An insurer shall]
adjust a rate submitted under Section 38.006 [payment required by
Subsection (b)(1) each plan year] by not more than [increasing the
payment by] the lesser of:
(1) the Medicare Ambulance Inflation Factor; [Index]
or
(2) 10 percent of the provider's previous calendar
year rates.
(g) This section expires September 1, 2027 [2025].
SECTION 6. Sections 1551.231(c) and (f), Insurance Code,
are amended to read as follows:
(c) A political subdivision may annually [The administrator
shall] adjust a rate submitted under Section 38.006 [payment
required by Subsection (b)(1) each plan year] by not more than
[increasing the payment by] the lesser of:
(1) the Medicare Ambulance Inflation Factor; [Index]
or
(2) 10 percent of the provider's previous calendar
year rates.
(f) This section expires September 1, 2027 [2025].
SECTION 7. Sections 1575.174(c) and (f), Insurance Code,
are amended to read as follows:
(c) A political subdivision may annually [The administrator
shall] adjust a rate submitted under Section 38.006 [payment
required by Subsection (b)(1) each plan year] by not more than
[increasing the payment by] the lesser of:
(1) the Medicare Ambulance Inflation Factor; [Index]
or
(2) 10 percent of the provider's previous calendar
year rates.
(f) This section expires September 1, 2027 [2025].
SECTION 8. Sections 1579.112(c) and (f), Insurance Code,
are amended to read as follows:
(c) A political subdivision may annually [The administrator
shall] adjust a rate submitted under Section 38.006 [payment
required by Subsection (b)(1) each plan year] by not more than
[increasing the payment by] the lesser of:
(1) the Medicare Ambulance Inflation Factor; [Index]
or
(2) 10 percent of the provider's previous calendar
year rates.
(f) This section expires September 1, 2027 [2025].
SECTION 9. The changes in law made by this Act apply only to
emergency medical services provided on or after the effective date
of this Act. Emergency medical services provided before the
effective date of this Act are governed by the law in effect
immediately before the effective date of this Act, and that law is
continued in effect for that purpose.
SECTION 10. This Act takes effect September 1, 2025.