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A BILL TO BE ENTITLED
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AN ACT
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relating to a disclosure statement on the out-of-pocket costs |
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incurred for health care services and supplies provided to |
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consumers receiving outpatient care at a hospital outpatient |
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clinic. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 324.101(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) Each facility shall develop, implement, and enforce |
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written policies for the billing of facility health care services |
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and supplies. The policies must address: |
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(1) any discounting of facility charges to an |
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uninsured consumer, subject to Chapter 552, Insurance Code; |
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(2) any discounting of facility charges provided to a |
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financially or medically indigent consumer who qualifies for |
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indigent services based on a sliding fee scale or a written charity |
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care policy established by the facility and the documented income |
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and other resources of the consumer; |
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(3) the providing of an itemized statement required by |
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Subsection (e); |
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(4) whether interest will be applied to any billed |
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service not covered by a third-party payor and the rate of any |
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interest charged; |
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(5) the procedure for handling complaints; |
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(6) the providing of a conspicuous written disclosure |
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to a consumer at the time the consumer is first admitted to the |
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facility or first receives services at the facility that: |
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(A) provides confirmation whether the facility |
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is a participating provider under the consumer's third-party payor |
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coverage on the date services are to be rendered based on the |
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information received from the consumer at the time the confirmation |
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is provided; |
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(B) informs consumers that a facility-based |
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physician who may provide services to the consumer while the |
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consumer is in the facility may not be a participating provider with |
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the same third-party payors as the facility; |
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(C) informs consumers that the consumer may |
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receive a bill for medical services from a facility-based physician |
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for the amount unpaid by the consumer's health benefit plan; |
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(D) informs consumers that the consumer may |
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request a listing of facility-based physicians who have been |
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granted medical staff privileges to provide medical services at |
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the facility; and |
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(E) informs consumers that the consumer may |
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request information from a facility-based physician on whether the |
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physician has a contract with the consumer's health benefit plan |
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and under what circumstances the consumer may be responsible for |
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payment of any amounts not paid by the consumer's health benefit |
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plan; |
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(7) the requirement that a facility provide a list, on |
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request, to a consumer to be admitted to, or who is expected to |
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receive services from, the facility, that contains the name and |
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contact information for each facility-based physician or |
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facility-based physician group that has been granted medical staff |
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privileges to provide medical services at the facility; [and] |
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(8) if the facility operates a website that includes a |
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listing of physicians who have been granted medical staff |
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privileges to provide medical services at the facility, the posting |
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on the facility's website of a list that contains the name and |
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contact information for each facility-based physician or |
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facility-based physician group that has been granted medical staff |
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privileges to provide medical services at the facility and the |
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updating of the list in any calendar quarter in which there are any |
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changes to the list; and |
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(9) for a health care service or supply provided on an |
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outpatient basis at a hospital outpatient clinic, the providing of |
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a conspicuous written disclosure statement to a consumer at the |
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time the consumer seeks outpatient care at the clinic that states: |
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"DEPENDING ON YOUR INSURANCE COVERAGE, YOU MAY INCUR MORE |
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OUT-OF-POCKET COSTS FOR A HEALTH CARE SERVICE OR SUPPLY PROVIDED AT |
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THIS CLINIC THAN YOU MIGHT OTHERWISE INCUR IF YOU RECEIVED THE |
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HEALTH CARE SERVICE OR SUPPLY AT A PHYSICIAN'S OFFICE." |
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SECTION 2. Section 324.101, Health and Safety Code, as |
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amended by this Act, applies only to a health care service or supply |
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provided at a hospital outpatient clinic on or after the effective |
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date of this Act. |
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SECTION 3. This Act takes effect September 1, 2011. |