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A BILL TO BE ENTITLED
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AN ACT
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relating to consumer protections against surprise billing. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter E, Chapter 17, Business & Commerce |
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Code, is amended by adding Section 17.464 to read as follows: |
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Sec. 17.464. SURPRISE BILLING. (a) In this section: |
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(1) "Emergency care" has the meaning assigned by |
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Section 1301.155. |
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(2) "Emergency care provider" means a physician, |
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health care practitioner, facility, or other health care provider |
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who provides emergency care. |
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(3) "Facility" has the meaning assigned by Section |
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324.001, Health and Safety Code. |
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(4) "Facility-based provider" means a physician or |
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health care provider who provides health care services to patients |
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of a health care facility. |
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(5) "Health care practitioner" means an individual who |
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is licensed to provide health care services. |
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(6) "Participating provider" means a physician or |
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health care provider who has contracted with an eligible plan |
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administrator to provide services to enrollees. |
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(7) "Surprise bill" means a bill received by an |
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insured or enrollee for amounts in addition to the applicable |
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copayment, coinsurance, and deductible: |
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(A) for services furnished by an out-of-network |
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facility-based provider who performed the service at a facility |
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that is an in-network provider; or |
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(B) for emergency care services furnished by an |
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out-of-network provider. |
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(b) For purposes of Section 17.46(a), the term "false, |
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misleading, or deceptive acts or practices" includes a |
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facility-based provider that bills an enrollee receiving health |
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care services described by Subsection (a)(7), except for the |
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enrollee's responsibility under the enrollee's health plan, |
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including an applicable copayment, coinsurance, or deductible. |
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(c) The consumer protection division may not bring an action |
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under Section 17.47 for an act or practice described by Subsection |
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(b) if the bill sent to the enrollee is less than five hundred |
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dollars. |
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(d) In an action brought under Section 17.47 to enforce this |
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section, the consumer protection division may request, and the |
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trier of fact may award the recovery of: |
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(1) reasonable attorney's fees and court costs; and |
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(2) the reasonable expenses incurred by the division |
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in obtaining any remedy available under Section 17.47, including |
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the cost of investigation, witness fees, and deposition expenses. |
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SECTION 2. This Act takes effect September 1, 2019. |