Bill Text: TX HB3102 | 2015-2016 | 84th Legislature | Introduced
Bill Title: Relating to the disclosure by health care practitioners and facilities of patient liability for payment for certain health care services.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2015-04-08 - Left pending in committee [HB3102 Detail]
Download: Texas-2015-HB3102-Introduced.html
84R11368 AJA-D | ||
By: Frullo | H.B. No. 3102 |
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relating to the disclosure by health care practitioners and | ||
facilities of patient liability for payment for certain health care | ||
services. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. The heading to Chapter 1456, Insurance Code, is | ||
amended to read as follows: | ||
CHAPTER 1456. DISCLOSURE OF PROVIDER STATUS AND PATIENT LIABILITY | ||
SECTION 2. Section 1456.003(a), Insurance Code, is amended | ||
to read as follows: | ||
(a) Each health benefit plan that provides health care | ||
through a provider network shall provide notice to its enrollees | ||
that: | ||
(1) a facility-based physician or other health care | ||
practitioner may not be included in the health benefit plan's | ||
provider network; and | ||
(2) subject to Subchapter D, Chapter 324, Health and | ||
Safety Code, a health care practitioner described by Subdivision | ||
(1) may balance bill the enrollee for amounts not paid by the health | ||
benefit plan. | ||
SECTION 3. Section 1456.007, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1456.007. HEALTH BENEFIT PLAN ESTIMATE OF CHARGES. A | ||
health benefit plan that must comply with this chapter under | ||
Section 1456.002 shall, on the request of an enrollee, provide an | ||
estimate of payments that will be made for any health care service | ||
or supply and shall also specify any applicable deductibles, | ||
copayments, or coinsurance[ |
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than the 10th business day after the date on which the estimate was | ||
requested. A health benefit plan must advise the enrollee that: | ||
(1) the actual payment and charges for the services or | ||
supplies will vary based upon the enrollee's actual medical | ||
condition and other factors associated with performance of medical | ||
services; and | ||
(2) subject to Subchapter D, Chapter 324, Health and | ||
Safety Code, the enrollee may be personally liable for the payment | ||
of services or supplies based upon the enrollee's health benefit | ||
plan coverage. | ||
SECTION 4. Chapter 324, Health and Safety Code, is amended | ||
by adding Subchapter D to read as follows: | ||
SUBCHAPTER D. PRICE DISCLOSURE | ||
Sec. 324.151. DEFINITIONS. Notwithstanding Section | ||
324.001, in this subchapter: | ||
(1) "Health care facility" means a hospital, emergency | ||
clinic, outpatient clinic, birthing center, ambulatory surgical | ||
center, or other facility providing health care services. | ||
(2) "Health care practitioner" means an individual who | ||
is licensed to provide and provides health care services. | ||
Sec. 324.152. PRICE DISCLOSURE BY HEALTH CARE PRACTITIONERS | ||
AND FACILITIES. (a) At least three business days before providing a | ||
health care service other than emergency care, as defined by | ||
Section 1301.155, Insurance Code, to a patient, a health care | ||
practitioner or facility must disclose to the patient the price | ||
that will be accepted as payment in full for the service. The | ||
disclosure required by this section must be provided in writing in a | ||
readily understandable manner. | ||
(b) Notwithstanding another provision of this subchapter, | ||
Chapter 1456, Insurance Code, or any other law, a health care | ||
practitioner or facility that does not make a disclosure required | ||
by this section before providing a health care service may not: | ||
(1) attempt to collect from the patient, by lawsuit or | ||
otherwise, any billed amount that would otherwise be owed by the | ||
patient for the service; | ||
(2) transfer or sell to a third party the right to | ||
collect any billed amount that would otherwise be owed by the | ||
patient for the service; or | ||
(3) furnish adverse information to a consumer | ||
reporting agency regarding any billed amount that would otherwise | ||
be owed by the patient for the service. | ||
Sec. 324.153. DUPLICATIVE ESTIMATE NOT REQUIRED. A | ||
facility that receives a request for an estimate under Section | ||
324.101(d) may provide, instead of an estimate, the price | ||
disclosure required by this subchapter. A facility that provides | ||
an estimate under Section 324.101(d) is not relieved of the | ||
obligation to provide a price disclosure under this subchapter. | ||
Sec. 324.154. PATIENT HELD HARMLESS. In addition to any | ||
other remedy provided by this subchapter or other law, a health care | ||
practitioner or facility shall hold a patient harmless from any | ||
damages resulting from the practitioner's or facility's violation | ||
of this subchapter. | ||
SECTION 5. The change in law made by this Act applies only | ||
to a service provided by a health care practitioner or facility on | ||
or after January 1, 2016. A service provided by a health care | ||
practitioner or facility before January 1, 2016, is 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 6. This Act takes effect September 1, 2015. |