81R8682 ALB-F

By: Nichols S.B. No. 1170

A BILL TO BE ENTITLED

AN ACT

relating to health care services provided or paid by a hospital district or public hospital.

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

SECTION 1. Section 61.066, Health and Safety Code, is amended by adding Subsection (c) to read as follows:

(c) A hospital district may recover an amount equal to the value of any fraudulently obtained health care services provided to a person disqualified under this section.

SECTION 2. Subchapter C, Chapter 61, Health and Safety Code, is amended by adding Section 61.067 to read as follows:

Sec. 61.067. SUBROGATION. (a) The filing of an application for or receipt of health care services provided or paid for by a hospital district or public hospital constitutes an assignment of the applicant's or recipient's right of recovery from:

(1) personal insurance;

(2) other sources; or

(3) another person for personal injury caused by the other person's negligence or wrong.

(b) A person who applies for or receives health care services shall inform the hospital district or public hospital, at the time of application or at any time during eligibility for services, of:

(1) any unsettled tort claim that may affect medical needs;

(2) any private accident or health insurance coverage that is or may become available; and

(3) any injury that is caused by the act or failure to act of some other person.

(c) An applicant or eligible resident shall inform the hospital district or public hospital of information required by Subsection (b) within 10 days of the date the person learns of the person's insurance coverage, tort claim, or potential cause of action.

(d) A claim for damages for personal injury does not constitute grounds for denying or discontinuing services under this chapter.

(e) A separate and distinct cause of action is created in favor of the hospital district or public hospital, and the hospital district or public hospital may, with the approval of the board of directors or managers, take direct civil action in any court of competent jurisdiction. A suit brought under this section does not need to be ancillary to or dependent on any other action.

(f) The hospital district's or public hospital's right of recovery under this section is limited to the amount of the cost of services paid by the hospital district or public hospital. Other subrogation rights granted under this section are limited to the cost of the services provided by the hospital district or public hospital.

(g) An applicant or eligible resident who knowingly and intentionally fails to disclose the information required by Subsection (b) is subject to denial of services under Section 61.066 following an administrative hearing.

(h) Procedures established by a hospital district or public hospital for administrative hearings under this section shall provide for appropriate due process, including procedures for appeals.

SECTION 3. This Act applies only to the filing of an application for services or receipt of services as described by Section 61.067, Health and Safety Code, as added by this Act, on or after the effective date of this Act. The filing of an application for services or receipt of services before the effective date of this Act is governed by the law in effect on the date of filing or receipt of services, and the prior law is continued in effect for that purpose.

SECTION 4. This Act takes effect September 1, 2009.