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A BILL TO BE ENTITLED
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AN ACT
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relating to the regulation of certain emergency care facilities. |
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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. UNCONSCIONABLE PRICE FOR CARE AT EMERGENCY |
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CARE FACILITY. (a) In this section: |
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(1) "Emergency care" means health care services |
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provided in an emergency care facility to evaluate and stabilize |
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medical conditions of a recent onset and severity, including severe |
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pain, that would lead a prudent layperson possessing an average |
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knowledge of medicine and health to believe that the individual's |
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condition, sickness, or injury is of such severity that failure to |
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get immediate medical care could: |
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(A) place the individual's health in serious |
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jeopardy; |
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(B) result in serious impairment to bodily |
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functions; |
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(C) result in serious dysfunction of a bodily |
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organ or part; |
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(D) result in serious disfigurement; or |
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(E) for a pregnant woman, result in serious |
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jeopardy to the health of the fetus. |
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(2) "Emergency care facility" means a hospital |
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emergency room, freestanding emergency medical care facility, or |
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comparable facility providing emergency care. |
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(3) "Freestanding emergency medical care facility" |
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has the meaning assigned by Section 254.001, Health and Safety |
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Code. |
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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 an emergency |
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care facility taking advantage of an individual's medical condition |
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by: |
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(1) providing emergency care at an unconscionable |
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price; or |
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(2) demanding or charging an unconscionable price for |
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or in connection with emergency care or other care at the facility. |
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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 price alleged to be unconscionable is less than 150 |
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percent of the average charge for the same or substantially similar |
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care provided to other individuals by a hospital emergency room |
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according to data collected under Chapter 108, Health and Safety |
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Code, and made available to the division, except as provided by |
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Subsection (d). |
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(d) If the attorney general determines that the consumer |
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protection division is unable to obtain the charge data described |
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by Subsection (c), the attorney general may adopt rules designating |
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another source of hospital charge data for use by the division in |
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establishing the average charge for emergency or other care |
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provided by hospital emergency rooms for purposes of Subsection |
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(c). |
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(e) 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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(f) This section does not create a private cause of action |
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for a false, misleading, or deceptive act or practice described by |
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Subsection (b). |
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SECTION 2. Sections 241.252(b), (c), and (e), Health and |
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Safety Code, are amended to read as follows: |
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(b) A facility described by Section 241.251 shall post |
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notice that: |
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(1) states: |
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(A) the facility is a freestanding emergency |
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medical care facility; |
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(B) the facility charges rates comparable to a |
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hospital emergency room [and may charge a facility fee]; |
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(C) a facility or a physician providing medical |
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care at the facility may [not] be an out-of-network [a
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participating] provider for [in] the patient's health benefit plan |
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provider network; and |
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(D) a physician providing medical care at the |
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facility may bill separately from the facility for the medical care |
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provided to a patient; and |
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(2) either: |
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(A) lists the health benefit plans in which the |
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facility is a network [participating] provider in the health |
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benefit plan's provider network; or |
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(B) states the facility is an out-of-network [not
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a participating] provider for [in] any health benefit plan provider |
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network. |
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(c) The notice required by this section must be posted |
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prominently and conspicuously: |
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(1) at the primary entrance to the facility; |
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(2) in each patient treatment room; |
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(3) at each location within the facility at which a |
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person pays for health care services; and |
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(4) on the home page of the facility's Internet website |
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in a font that is larger than and contrasts with the font on the |
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remainder of the page. |
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(e) Notwithstanding Subsection (c), a facility that is a |
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network [participating] provider in one or more health benefit plan |
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provider networks complies with Subsection (b)(2) if the facility: |
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(1) provides notice on the home page of the facility's |
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Internet website listing the health benefit plans in which the |
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facility is a network [participating] provider in the health |
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benefit plan's provider network; and |
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(2) provides to a patient written confirmation of |
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whether the facility is a network [participating] provider in the |
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patient's health benefit plan's provider network. |
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SECTION 3. Sections 254.155(a), (b), and (d), Health and |
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Safety Code, are amended to read as follows: |
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(a) A facility shall post notice that: |
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(1) states: |
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(A) the facility is a freestanding emergency |
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medical care facility; |
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(B) the facility charges rates comparable to a |
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hospital emergency room [and may charge a facility fee]; |
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(C) a facility or a physician providing medical |
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care at the facility may [not] be an out-of-network [a
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participating] provider for [in] the patient's health benefit plan |
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provider network; and |
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(D) a physician providing medical care at the |
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facility may bill separately from the facility for the medical care |
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provided to a patient; and |
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(2) either: |
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(A) lists the health benefit plans in which the |
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facility is a network [participating] provider in the health |
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benefit plan's provider network; or |
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(B) states the facility is an out-of-network [not
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a participating] provider for [in] any health benefit plan provider |
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network. |
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(b) The notice required by this section must be posted |
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prominently and conspicuously: |
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(1) at the primary entrance to the facility; |
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(2) in each patient treatment room; |
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(3) at each location within the facility at which a |
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person pays for health care services; and |
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(4) on the home page of the facility's Internet website |
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in a font that is larger than and contrasts with the font on the |
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remainder of the page. |
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(d) Notwithstanding Subsection (b), a facility that is a |
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network [participating] provider in one or more health benefit plan |
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provider networks complies with Subsection (a)(2) if the facility: |
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(1) provides notice on the home page of the facility's |
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Internet website listing the health benefit plans in which the |
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facility is a network [participating] provider in the health |
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benefit plan's provider network; and |
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(2) provides to a patient written confirmation of |
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whether the facility is a network [participating] provider in the |
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patient's health benefit plan's provider network. |
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SECTION 4. Subchapter D, Chapter 254, Health and Safety |
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Code, is amended by adding Section 254.156 to read as follows: |
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Sec. 254.156. REQUIREMENTS AND RESTRICTIONS ON |
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OUT-OF-NETWORK FACILITIES. (a) A facility may not post the name or |
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logo of a health benefit plan issuer on the facility's Internet |
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website if the facility is an out-of-network provider for any of the |
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issuer's health benefit plans. |
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(b) If a facility is an out-of-network provider for a |
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patient's health benefit plan provider network, the facility on the |
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patient's arrival at the facility shall: |
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(1) provide to the patient or the patient's legally |
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authorized representative a written disclosure statement that |
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outlines the range of fees, including facility and observation |
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fees, that may result from the patient's visit; and |
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(2) obtain the signature of the patient or the |
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patient's legally authorized representative on the disclosure |
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statement described by Subdivision (1) before providing health care |
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services to the patient unless the patient's medical condition |
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requires immediate medical intervention. |
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SECTION 5. Section 254.205(c), Health and Safety Code, is |
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amended to read as follows: |
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(c) Each [The amount of the penalty may not exceed $1,000
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for each violation, and each] day a violation continues or occurs is |
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a separate violation for purposes of imposing a penalty. The total |
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amount of the penalty assessed for a violation continuing or |
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occurring on separate days under this subsection may not exceed |
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$25,000 [$5,000]. |
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SECTION 6. Subtitle B, Title 4, Health and Safety Code, is |
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amended by adding Chapter 260B to read as follows: |
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CHAPTER 260B. EMERGENCY CARE FACILITIES |
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Sec. 260B.0001. DEFINITIONS. In this chapter: |
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(1) "Emergency care" has the meaning assigned by |
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Section 17.464, Business & Commerce Code. |
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(2) "Emergency care facility" means a hospital |
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emergency room, freestanding emergency medical care facility, or |
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comparable facility providing emergency care. |
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(3) "Freestanding emergency medical care facility" |
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has the meaning assigned by Section 254.001. |
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Sec. 260B.0002. FACILITY FEE PROHIBITED. An emergency care |
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facility may not charge a patient who receives nonemergency health |
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care services a facility fee. |
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Sec. 260B.0003. DISSEMINATION OF CERTAIN FALSE OR |
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MISLEADING INFORMATION PROHIBITED. An emergency care facility may |
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not post on the facility's Internet website or disseminate by any |
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method false or misleading information on whether the facility is a |
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network provider in a health benefit plan provider network. |
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SECTION 7. This Act takes effect September 1, 2019. |