By Madla S.B. No. 512
76R1126 MCK-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to billing medical patients and the penalty for certain
1-3 pricing practices.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 18A(g), Texas Health Maintenance
1-6 Organization Act (Article 20A.18A, Vernon's Texas Insurance Code),
1-7 as added by Chapter 1026, Acts of the 75th Legislature, Regular
1-8 Session, 1997, is amended to read as follows:
1-9 (g) All contracts or other agreements between a health
1-10 maintenance organization and a physician or provider shall specify
1-11 that the physician or provider will hold an enrollee harmless for
1-12 payment of the cost of covered health care services in the event
1-13 the health maintenance organization fails to pay the provider for
1-14 the full amount charged by the provider for the covered health care
1-15 services.
1-16 SECTION 2. Article 21.79F(b), Insurance Code, is amended to
1-17 read as follows:
1-18 (b) An offense under this article is a felony of the third
1-19 degree [Class B misdemeanor].
1-20 SECTION 3. Chapter 6, Title 71, Revised Statutes, is amended
1-21 by adding Article 4496 to read as follows:
1-22 Art. 4496. BALANCE BILLING PROHIBITED. (a) In this
1-23 section, "health care provider" means a person who is licensed,
1-24 certified, or otherwise authorized by the laws of this state to
2-1 provide health care in the ordinary course of business or practice
2-2 of a profession.
2-3 (b) A health care provider, except a hospital governed by
2-4 Section 241.0261, Health and Safety Code, may not bill a patient
2-5 for health care services in violation of Section 18A(g), Texas
2-6 Health Maintenance Organization Act (Article 20A.18A, Vernon's
2-7 Texas Insurance Code), as added by Chapter 1026, Acts of the 75th
2-8 Legislature, Regular Session, 1997.
2-9 (c) A health care provider who violates this article may be
2-10 disciplined by the appropriate licensing agency.
2-11 SECTION 4. Subchapter B, Chapter 241, Health and Safety
2-12 Code, is amended by adding Section 241.0261 to read as follows:
2-13 Sec. 241.0261. BALANCE BILLING PROHIBITED. A hospital may
2-14 not bill a patient for health care services in violation of Section
2-15 18A(g), Texas Health Maintenance Organization Act (Article 20A.18A,
2-16 Vernon's Texas Insurance Code), as added by Chapter 1026, Acts of
2-17 the 75th Legislature, Regular Session, 1997.
2-18 SECTION 5. (a) This Act takes effect September 1, 1999.
2-19 (b) Sections 1, 3, and 4 of this Act apply only to acts or
2-20 omissions occurring on or after the effective date of this Act.
2-21 (c) The change in law made by Section 2 of this Act applies
2-22 only to an offense committed on or after the effective date of this
2-23 Act. For the purposes of this section, an offense is committed
2-24 before the effective date of this Act if any element of the offense
2-25 occurs before that date.
2-26 (d) An offense committed before the effective date of this
2-27 Act is covered by the law in effect when the offense was committed,
3-1 and the former law is continued in effect for that purpose.
3-2 SECTION 6. The importance of this legislation and the
3-3 crowded condition of the calendars in both houses create an
3-4 emergency and an imperative public necessity that the
3-5 constitutional rule requiring bills to be read on three several
3-6 days in each house be suspended, and this rule is hereby suspended.