84R11368 AJA-D
 
  By: Frullo H.B. No. 3102
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  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[, or other amounts for which the
  enrollee is responsible].  The estimate must be provided not later
  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.