1-1 By: Madla S.B. No. 830
1-2 (In the Senate - Filed March 3, 1999; March 4, 1999, read
1-3 first time and referred to Committee on Health Services;
1-4 March 25, 1999, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 5, Nays 0; March 25, 1999,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 830 By: Madla
A BILL TO BE ENTITLED
1-8 AN ACT
1-9 relating to billing policies of certain health care professionals
1-10 and facilities; providing administrative penalties.
1-11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12 SECTION 1. Subsection (d), Section 241.154, Health and
1-13 Safety Code, is amended to read as follows:
1-14 (d) A hospital may not charge a fee for:
1-15 (1) providing health care information under Subsection
1-16 (b) to the extent the fee is prohibited under Subchapter M, Chapter
1-17 161;
1-18 (2) a patient to examine the patient's own health care
1-19 information;
1-20 (3) providing an itemized statement of billed services
1-21 to a patient or third-party payor, except as provided under Section
1-22 311.002(f) [311.002(e)]; or
1-23 (4) health care information relating to treatment or
1-24 hospitalization for which workers' compensation benefits are being
1-25 sought, except to the extent permitted under Chapter 408, Labor
1-26 Code.
1-27 SECTION 2. Section 311.002, Health and Safety Code, is
1-28 amended to read as follows:
1-29 Sec. 311.002. ITEMIZED STATEMENT OF BILLED SERVICES.
1-30 (a) Each hospital shall develop, implement, and enforce a written
1-31 policy for the billing of hospital services and supplies. The
1-32 policy must include:
1-33 (1) a periodic review of the itemized statements
1-34 required by Subsection (b); and
1-35 (2) a procedure for handling complaints relating to
1-36 billed services.
1-37 (b) Not later than the 30th [10th] business day after the
1-38 date of the hospital discharge of a person who receives hospital
1-39 services, the hospital shall provide on request [have available] an
1-40 itemized statement of the billed services provided to the person.
1-41 The itemized statement must:
1-42 (1) be printed in a conspicuous manner;
1-43 (2) list the date services and supplies were provided;
1-44 (3) state whether:
1-45 (A) a claim has been submitted to a third party
1-46 payor; and
1-47 (B) a third party payor has paid the claim;
1-48 (4) if payment is not required, state that payment is
1-49 not required:
1-50 (A) in a typeface that is bold-faced,
1-51 capitalized, underlined, or otherwise set out from surrounding
1-52 written material; or
1-53 (B) by other reasonable means so as to be
1-54 conspicuous that payment is not required; and
1-55 (5) contain the telephone number of the facility to
1-56 call for an explanation of acronyms, abbreviations, and numbers
1-57 used to describe the services provided or supplies used or any
1-58 other questions regarding the bill.
1-59 (c) [(b)] Before a person is discharged from a hospital, the
1-60 hospital shall inform the person of the availability of the
1-61 statement.
1-62 (d) [(c)] To be entitled to receive a statement, a person
1-63 must request the statement not later than one year after the date
1-64 on which the person is discharged from the hospital. The hospital
2-1 shall provide the statement to the person not later than the 30th
2-2 [10th] day after the date on which the person requests the
2-3 statement.
2-4 (e) [(d)] A hospital shall provide an itemized statement of
2-5 billed services to a third party payor who is actually or
2-6 potentially responsible for paying all or part of the billed
2-7 services provided to a patient and who has received a claim for
2-8 payment of those services. To be entitled to receive a statement,
2-9 the third party payor must request the statement from the hospital
2-10 and must have received a claim for payment. The request must be
2-11 made not later than one year after the date on which the payor
2-12 received the claim for payment. The hospital shall provide the
2-13 statement to the payor not later than the 30th [10th] day after the
2-14 date on which the payor requests the statement. If a third party
2-15 payor receives a claim for payment of part but not all of the
2-16 billed services, the third party payor may request an itemized
2-17 statement of only the billed services for which payment is claimed
2-18 or to which any deduction or copayment applies.
2-19 (f) [(e)] If a person, including a third party payor,
2-20 requests more than two copies of the statement, the hospital may
2-21 charge a reasonable fee for the third and subsequent copies
2-22 provided to that person. The fee may not exceed the hospital's
2-23 cost to copy, process, and deliver the copy to the person.
2-24 (g) [(f)] The Texas Department of Health or other
2-25 appropriate licensing agency may enforce this section by assessing
2-26 an administrative penalty, obtaining an injunction, or providing
2-27 [by] any other appropriate remedy, including suspending, revoking,
2-28 or refusing to renew a hospital's license.
2-29 (h) [(g)] In this section, "hospital" includes:
2-30 (1) a hospital licensed under Chapter 241;
2-31 (2) a treatment facility licensed under Chapter 464;
2-32 and
2-33 (3) [(2)] a mental health facility licensed under
2-34 Chapter 577.
2-35 (i) [(h)] This section does not apply to a hospital
2-36 maintained or operated by the federal government.
2-37 SECTION 3. This Act takes effect September 1, 1999, and
2-38 applies only to acts or omissions occurring on or after that date.
2-39 SECTION 4. The importance of this legislation and the
2-40 crowded condition of the calendars in both houses create an
2-41 emergency and an imperative public necessity that the
2-42 constitutional rule requiring bills to be read on three several
2-43 days in each house be suspended, and this rule is hereby suspended.
2-44 * * * * *