By Bailey H.B. No. 761
74R2294 KLL-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to cost estimates for procedures and services by hospitals
1-3 and nursing homes and to reports on the status of health care
1-4 services.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subchapter A, Chapter 241, Health and Safety
1-7 Code, is amended by adding Sections 241.006 and 241.007 to read as
1-8 follows:
1-9 Sec. 241.006. COST ESTIMATE. (a) The commissioner of
1-10 health shall require hospitals to publish cost estimates for
1-11 procedures and services provided by the hospital.
1-12 (b) The commissioner shall require hospitals to furnish on
1-13 request a written estimate to a prospective patient of the average
1-14 charges for health services related to a particular diagnostic
1-15 condition or medical procedure to be provided by the hospital to
1-16 the prospective patient.
1-17 (c) A request for a cost estimate by a prospective patient
1-18 must be in writing and include in the request a written medical
1-19 diagnosis made by a health care practitioner licensed to provide
1-20 the diagnosis. A hospital may require the prospective patient to
1-21 provide the hospital with information about the prospective
1-22 patient's age and gender and any other information that will allow
1-23 the hospital to provide a more accurate estimate.
1-24 (d) A hospital shall provide notice to the public that the
2-1 hospital will provide an estimate of charges for diagnostic
2-2 conditions or medical procedures. Notice may be given by posting
2-3 in a public area of the hospital a statement of the procedure for
2-4 requesting a cost estimate.
2-5 (e) A hospital shall publish notice that the hospital will
2-6 provide an estimate of charges for diagnostic conditions or medical
2-7 procedures in any advertisement or promotional material of the
2-8 hospital.
2-9 Sec. 241.007. REPORT. The commissioner of health shall
2-10 prepare a report regarding the status and operations of hospitals
2-11 in the state. The report must be submitted to the governor and
2-12 legislature not later than February 1 of each odd-numbered year.
2-13 The report must contain information, analysis, and recommendations
2-14 concerning:
2-15 (1) the status of the health care cost problem,
2-16 including the costs faced by employers and individuals;
2-17 (2) the status of competitive forces in the market for
2-18 health services, the market for health plans, and the effect of
2-19 competitive forces on the health care cost problem;
2-20 (3) the feasibility and cost-effectiveness of
2-21 facilitating development of strengthened competitive forces through
2-22 state initiatives;
2-23 (4) the feasibility of limiting health care costs by
2-24 means other than competitive forces, including direct forms of
2-25 government intervention, such as price regulation;
2-26 (5) the overall status of access to adequate health
2-27 services by citizens of the state, the scope of financial and
3-1 geographic barriers to access, the effect of competitive forces on
3-2 access, and the prospects for access to health care services
3-3 improving or degenerating; and
3-4 (6) the feasibility and cost-effectiveness of
3-5 enhancing access to adequate health services for citizens of this
3-6 state through state initiatives.
3-7 SECTION 2. Subchapter A, Chapter 242, Health and Safety
3-8 Code, is amended by adding Sections 242.015 and 242.016 to read as
3-9 follows:
3-10 Sec. 242.015. COST ESTIMATE. (a) The commissioner of human
3-11 services shall require nursing homes to publish cost estimates for
3-12 procedures and services provided by the nursing home.
3-13 (b) The commissioner shall require nursing homes to furnish
3-14 on request a written estimate to a prospective patient of the
3-15 average charges for health services related to a particular
3-16 diagnostic condition or medical procedure to be provided by the
3-17 nursing home to the prospective patient.
3-18 (c) A request for a cost estimate by a prospective patient
3-19 must be in writing and include in the request a written medical
3-20 diagnosis made by a health care practitioner licensed to provide
3-21 the diagnosis. A nursing home may require the prospective patient
3-22 to provide the nursing home with information about the prospective
3-23 patient's age and gender and any other information that will allow
3-24 the nursing home to provide a more accurate estimate.
3-25 (d) A nursing home shall provide notice to the public that
3-26 the nursing home will provide an estimate of charges for diagnostic
3-27 conditions or medical procedures. Notice may be given by posting
4-1 in a public area of the nursing home a statement of the procedure
4-2 for requesting a cost estimate.
4-3 (e) A nursing home shall publish notice that the nursing
4-4 home will provide an estimate of charges for diagnostic conditions
4-5 or medical procedures in any advertisement or promotional material
4-6 of the nursing home.
4-7 Sec. 242.016. REPORT. The commissioner of human services
4-8 shall prepare a report regarding the status and operations of
4-9 nursing homes in the state. The report must be submitted to the
4-10 governor and legislature not later than February 1 of each
4-11 odd-numbered year. The report must contain information, analysis,
4-12 and recommendations concerning:
4-13 (1) the status of the health care cost problem,
4-14 including the costs faced by employers and individuals;
4-15 (2) the status of competitive forces in the market for
4-16 health services, the market for health plans, and the effect of
4-17 competitive forces on the health care cost problem;
4-18 (3) the feasibility and cost-effectiveness of
4-19 facilitating development of strengthened competitive forces through
4-20 state initiatives;
4-21 (4) the feasibility of limiting health care costs by
4-22 means other than competitive forces, including direct forms of
4-23 government intervention, such as price regulation;
4-24 (5) the overall status of access to adequate health
4-25 services by citizens of the state, the scope of financial and
4-26 geographic barriers to access, the effect of competitive forces on
4-27 access, and the prospects for access to health care services
5-1 improving or degenerating; and
5-2 (6) the feasibility and cost-effectiveness of
5-3 enhancing access to adequate health services for citizens of this
5-4 state through state initiatives.
5-5 SECTION 3. This Act takes effect September 1, 1995.
5-6 SECTION 4. The importance of this legislation and the
5-7 crowded condition of the calendars in both houses create an
5-8 emergency and an imperative public necessity that the
5-9 constitutional rule requiring bills to be read on three several
5-10 days in each house be suspended, and this rule is hereby suspended.