81R31340 YDB-D

By: Coleman, Davis of Harris H.B. No. 3749

Substitute the following for H.B. No. 3749:

By: Naishtat C.S.H.B. No. 3749

A BILL TO BE ENTITLED

AN ACT

relating to the creation of an interim committee on, and a study of, the itemized billing statements of certain health care facilities.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. DEFINITIONS. In this Act:

(1) "Department" means the Department of State Health Services.

(2) "Health care facility" means:

(A) an ambulatory surgical center licensed under Chapter 243, Health and Safety Code;

(B) a birthing center licensed under Chapter 244, Health and Safety Code; or

(C) a hospital licensed under Chapter 241, Health and Safety Code.

(3) "Interim committee" means the committee appointed under Section 3 of this Act.

SECTION 2. DATA COLLECTION. (a) The department shall collect information concerning the itemized billing statements of health care facilities, including information concerning the unit prices charged to health care facilities by manufacturers, suppliers, or providers for:

(1) medical hardware provided to patients by health care facilities;

(2) devices or implants provided to patients by health care facilities;

(3) prescription specialty drugs or drug protocols dispensed to patients by health care facilities; and

(4) health care services provided to patients by health services providers for health care facilities.

(b) A health care facility shall provide information as required by the department under this Act. A health care facility may not include in a contract to which the health care facility is a party and that is entered into or renewed on or after the effective date of this Act, a provision that prohibits the health care facility from disclosing as required under this section:

(1) information on the unit price charged to the health care facility by a manufacturer, supplier, or provider of any medical hardware, device, implant, prescription specialty drug, drug protocol, or service; or

(2) other pricing information related to the contract.

(c) The department shall provide the information collected under this section to the interim committee.

SECTION 3. INTERIM COMMITTEE; STUDY; REPORT. (a) The interim committee consists of the following six members:

(1) three senators appointed by the lieutenant governor; and

(2) three state representatives appointed by the speaker of the house of representatives.

(b) The interim committee shall elect a presiding officer from among its members. The committee shall convene at the call of the presiding officer.

(c) The interim committee shall hold public hearings on the transparency of itemized billing statements of health care facilities and include information gathered in the hearings in the study conducted under this section.

(d) The interim committee shall conduct a study concerning transparency of itemized billing statements of health care facilities. The study must examine:

(1) to the extent the unit prices charged to facilities by manufacturers, suppliers, and providers reflect discounts, rebates, or other adjustments to the price billed, the manner in which the billing statement accurately reflects the actual unit prices charged to and paid by facilities and whether the billing statement includes invoices or other sufficient documentation to support the actual unit prices paid;

(2) the effects of health care facility billing practices on patient access to health care and on third-party payors, including the effects of pricing and discounting practices on the uninsured and underinsured and on insurers, governmental payors, and other third-party payors;

(3) the economic consequences of health care facility billing practices on consumers and third-party payors, including the effects of bankruptcy and denied claims;

(4) the resolution of patient complaints on health care facility billed charges and billing practices, including resolution through reduction in charges to a patient through any available charity care or discounts offered by the health care facility for patients; and

(5) the effects of health care facility billing practices related to any increase in the amount of the billed unit prices presented to consumers and third-party payors compared to the actual unit prices charged to and paid by facilities.

(e) Not later than December 1, 2010, the interim committee shall submit to the governor, lieutenant governor, and speaker of the house of representatives a report on the results of the study, including recommendations for legislation to address issues identified in the study.

SECTION 4. EXPIRATION. This Act expires September 1, 2011.

SECTION 5. EFFECTIVE DATE. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2009.