By Hochberg H.B. No. 213 76R1077(1) DLF A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to certain claims for health care services. 1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-4 SECTION 1. Title 6, Civil Practice and Remedies Code, is 1-5 amended by adding Chapter 146 to read as follows: 1-6 CHAPTER 146. CERTAIN CLAIMS BY HEALTH CARE SERVICE PROVIDERS BARRED 1-7 Sec. 146.001. DEFINITION. In this chapter: 1-8 (1) "Health benefit plan" means a plan or arrangement 1-9 under which medical or surgical expenses are paid for or reimbursed 1-10 or health care services are arranged for or provided. The term 1-11 includes: 1-12 (A) an individual, group, blanket, or franchise 1-13 insurance policy, insurance agreement, or group hospital service 1-14 contract; 1-15 (B) an evidence of coverage or group subscriber 1-16 contract issued by a health maintenance organization or an approved 1-17 nonprofit health corporation; 1-18 (C) a benefit plan provided by a multiple 1-19 employer welfare arrangement or another analogous benefit 1-20 arrangement; 1-21 (D) a workers' compensation insurance policy; or 1-22 (E) a motor vehicle insurance policy, to the 1-23 extent the policy provides personal injury protection or medical 1-24 payments coverage. 1-25 (2) "Health care service provider" means a person who, 1-26 under a license or other grant of authority issued by this state, 2-1 provides health care services the costs of which may be paid for or 2-2 reimbursed under a health benefit plan. 2-3 Sec. 146.002. TIMELY PATIENT BILLING REQUIRED. (a) A 2-4 health care service provider shall bill a patient or other 2-5 responsible person for services provided to the patient not later 2-6 than the first day of the 11th month after the date the services 2-7 are provided. 2-8 (b) For purposes of this section, the date of billing is the 2-9 date on which the health care service provider's bill is mailed to 2-10 the patient or responsible person, postage prepaid, at the address 2-11 of the patient or responsible person as shown on the health care 2-12 service provider's records. 2-13 Sec. 146.003. CERTAIN CLAIMS BARRED. (a) A health care 2-14 service provider who violates Section 146.002 may not recover from 2-15 the patient any amount which the patient would have been entitled 2-16 to receive as payment or reimbursement under a health benefit plan 2-17 had the provider complied with Section 146.002. 2-18 (b) If recovery from a patient is barred under this section, 2-19 the health care service provider may not recover from any other 2-20 person who would otherwise be responsible for the patient's debt. 2-21 SECTION 2. This Act takes effect September 1, 1999. 2-22 SECTION 3. This Act applies only to health care services 2-23 provided on or after the effective date of this Act. Health care 2-24 services that are provided before the effective date of this Act 2-25 are governed by the law applicable to the services immediately 2-26 before the effective date of this Act, and that law is continued in 2-27 effect for that purpose. 3-1 SECTION 4. The importance of this legislation and the 3-2 crowded condition of the calendars in both houses create an 3-3 emergency and an imperative public necessity that the 3-4 constitutional rule requiring bills to be read on three several 3-5 days in each house be suspended, and this rule is hereby suspended.