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.