| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to notice of health benefit plan provider network status |
|
|
provided by certain freestanding emergency medical care |
|
|
facilities. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 241.252, Health and Safety Code, is |
|
|
amended by amending Subsection (b) and adding Subsection (e) to |
|
|
read as follows: |
|
|
(b) A facility described by Section 241.251 shall post |
|
|
notice that: |
|
|
(1) states: |
|
|
(A) [(1) that] the facility is a freestanding |
|
|
emergency medical care facility; |
|
|
(B) [(2) that] the facility charges rates |
|
|
comparable to a hospital emergency room and may charge a facility |
|
|
fee; |
|
|
(C) [(3) that] a facility or a physician |
|
|
providing medical care at the facility may not be a participating |
|
|
provider in the patient's health benefit plan provider network; and |
|
|
(D) [(4) that] a physician providing medical |
|
|
care at the facility may bill separately from the facility for the |
|
|
medical care provided to a patient; and |
|
|
(2) either: |
|
|
(A) lists the health benefit plans in which the |
|
|
facility is a participating provider in the health benefit plan's |
|
|
provider network; or |
|
|
(B) states the facility is not a participating |
|
|
provider in any health benefit plan provider network. |
|
|
(e) Notwithstanding Subsection (c), a facility that is a |
|
|
participating provider in one or more health benefit plan provider |
|
|
networks complies with Subsection (b)(2) if the facility: |
|
|
(1) provides notice on the facility's Internet website |
|
|
listing the health benefit plans in which the facility is a |
|
|
participating provider in the health benefit plan's provider |
|
|
network; and |
|
|
(2) provides to a patient written confirmation of |
|
|
whether the facility is a participating provider in the patient's |
|
|
health benefit plan's provider network. |
|
|
SECTION 2. Section 254.155, Health and Safety Code, is |
|
|
amended by amending Subsection (a) and adding Subsection (d) to |
|
|
read as follows: |
|
|
(a) A facility shall post notice that: |
|
|
(1) states: |
|
|
(A) [(1) that] the facility is a freestanding |
|
|
emergency medical care facility; |
|
|
(B) [(2) that] the facility charges rates |
|
|
comparable to a hospital emergency room and may charge a facility |
|
|
fee; |
|
|
(C) [(3) that] a facility or a physician |
|
|
providing medical care at the facility may not be a participating |
|
|
provider in the patient's health benefit plan provider network; and |
|
|
(D) [(4) that] a physician providing medical |
|
|
care at the facility may bill separately from the facility for the |
|
|
medical care provided to a patient; and |
|
|
(2) either: |
|
|
(A) lists the health benefit plans in which the |
|
|
facility is a participating provider in the health benefit plan's |
|
|
provider network; or |
|
|
(B) states the facility is not a participating |
|
|
provider in any health benefit plan provider network. |
|
|
(d) Notwithstanding Subsection (b), a facility that is a |
|
|
participating provider in one or more health benefit plan provider |
|
|
networks complies with Subsection (a)(2) if the facility: |
|
|
(1) provides notice on the facility's Internet website |
|
|
listing the health benefit plans in which the facility is a |
|
|
participating provider in the health benefit plan's provider |
|
|
network; and |
|
|
(2) provides to a patient written confirmation of |
|
|
whether the facility is a participating provider in the patient's |
|
|
health benefit plan's provider network. |
|
|
SECTION 3. This Act takes effect September 1, 2017. |