85R21927 LED-D

By: Oliverson, Smithee, Cook, Turner, et al. H.B. No. 3276

Substitute the following for H.B. No. 3276:

By: Phillips C.S.H.B. No. 3276

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.