85R10101 SCL-F

By: Collier H.B. No. 1832

A BILL TO BE ENTITLED

AN ACT

relating to disclosures regarding the provision of services by certain health care providers in certain health care facilities.

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

SECTION 1. Section 324.001, Health and Safety Code, is amended by amending Subdivision (8) and adding Subdivisions (9) and (10) to read as follows:

(8) "Facility-based physician" means an individual licensed to practice medicine in this state:

(A) to whom the facility has granted clinical privileges; and

(B) who provides medical or health care services to patients in the facility under those clinical privileges [a radiologist, an anesthesiologist, a pathologist, an emergency department physician, a neonatologist, or an assistant surgeon].

(9) "Facility-based provider" means a facility-based physician or other health care practitioner who provides medical or health care services to patients in a facility.

(10) "Health care practitioner" means an individual issued a license, certificate, or other authorization to provide health care services. The term does not include a physician.

SECTION 2. Section 324.101(a), Health and Safety Code, is amended to read as follows:

(a) Each facility shall develop, implement, and enforce written policies for the billing of facility health care services and supplies. The policies must address:

(1) any discounting of facility charges to an uninsured consumer, subject to Chapter 552, Insurance Code;

(2) any discounting of facility charges provided to a financially or medically indigent consumer who qualifies for indigent services based on a sliding fee scale or a written charity care policy established by the facility and the documented income and other resources of the consumer;

(3) the providing of an itemized statement required by Subsection (e);

(4) whether interest will be applied to any billed service not covered by a third-party payor and the rate of any interest charged;

(5) the procedure for handling complaints;

(6) the providing of a conspicuous written disclosure to a consumer at the time the consumer is first admitted to the facility or first receives services at the facility that:

(A) provides confirmation whether the facility is a participating provider under the consumer's third-party payor coverage on the date services are to be rendered based on the information received from the consumer at the time the confirmation is provided;

(B) informs the consumer that while the consumer is in the facility, the consumer may receive services from a facility-based provider due to:

(i) planned or anticipated events or services;

(ii) facility scheduling conflicts;

(iii) facility staff changes;

(iv) medical complications; or

(v) other reasons associated with the care of the consumer;

(C) informs the consumer [consumers] that a facility-based provider [physician] who may provide services to the consumer while the consumer is in the facility may not be a participating provider with the same third-party payors as the facility;

(D) [(C)] informs the consumer [consumers] that the consumer may receive a bill for [medical] services from a facility-based provider [physician] for the amount unpaid by the consumer's health benefit plan;

(E) [(D)] informs the consumer [consumers] that the consumer may request a listing of facility-based providers [physicians] who have been granted clinical [medical staff] privileges to provide medical services or health care services at the facility that:

(i) includes the contact information of each provider; and

(ii) identifies each provider by type of license or other certification, any specialty, and type of clinical privileges;

(F) [(E)] informs the consumer [consumers] that the consumer may request information from a facility-based provider [physician] on whether the provider [physician] has a contract with the consumer's health benefit plan and under what circumstances the consumer may be responsible for payment of any amounts not paid by the consumer's health benefit plan;

(G) informs the consumer that laboratory services related to the consumer's facility admission, stay, or services may be provided by a laboratory that may not be a participating provider with the same third-party payors as the facility; and

(H) informs the consumer that the consumer may request from the facility a list of the names and contact information of the laboratories that typically provide laboratory services for the facility;

(7) the requirement that a facility provide a list, on request, to a consumer to be admitted to, or who is expected to receive services from, the facility, that contains the name and contact information for each facility-based provider [physician] or facility-based provider [physician] group that has been granted clinical [medical staff] privileges to provide medical services or health care services at the facility; and

(8) if the facility operates a website that includes a listing of individuals licensed to provide medical services or health care services [physicians] who have been granted clinical [medical staff] privileges to provide [medical] services at the facility, the posting on the facility's website of a list that contains the name and contact information for each facility-based provider [physician] or facility-based provider [physician] group that has been granted clinical [medical staff] privileges to provide [medical] services at the facility and the updating of the list in any calendar quarter in which there are any changes to the list.

SECTION 3. The changes in law made by this Act apply only to charges for a health care service or supply provided on or after the effective date of this Act. Charges for a health care service or supply provided before the effective date of this Act are governed by the law as it existed immediately before the effective date of this Act, and that law is continued in effect for that purpose.

SECTION 4. This Act takes effect September 1, 2017.