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.
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