S.B. No. 790
  relating to county and municipal authority to balance bill for
  county or municipal air or ground ambulance services and to a study
  regarding billing by ground ambulance service providers.
         SECTION 1.  Section 113.902(a), Local Government Code, is
  amended to read as follows:
         (a)  Except as provided by Section 140.013, the [The] county
  treasurer shall direct prosecution for the recovery of any debt
  owed to the county, as provided by law, and shall supervise the
  collection of the debt.
         SECTION 2.  Chapter 140, Local Government Code, is amended
  by adding Section 140.013 to read as follows:
  AMBULANCE SERVICES. (a)  "Balance billing" means the practice of
  charging an enrollee in a health benefit plan to recover from the
  enrollee the balance of a health care provider's fee for a service
  received by the enrollee from the health care provider that is not
  fully reimbursed by the enrollee's health benefit plan.
         (b)  A county or municipality may elect to consider a health
  benefit plan payment towards a claim for air or ground ambulance
  services provided by the county or municipality as payment in full
  for those services regardless of the amount the county or
  municipality charged for those services.
         (c)  A county or municipality may not practice balance
  billing for a claim for which the county or municipality makes an
  election under Subsection (b).
         SECTION 3.  (a)  In this section, "department" means the
  Texas Department of Insurance.
         (b)  The department shall conduct a study on the balance
  billing practices of ground ambulance service providers, the
  variations in prices for ground ambulance services, the proportion
  of ground ambulances that are in-network, trends in network
  inclusion, and factors contributing to the network status of ground
  ambulances.  The department may seek the assistance of the
  Department of State Health Services in conducting the study.
         (c)  Not later than December 1, 2022, the department shall
  provide a written report of the results of the study conducted under
  Subsection (b) of this section to the governor, lieutenant
  governor, speaker of the house of representatives, and members of
  the standing committees of the legislature with primary
  jurisdiction over the department.
         (d)  This section expires September 1, 2023.
         SECTION 4.  This Act takes effect September 1, 2021.
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
         I hereby certify that S.B. No. 790 passed the Senate on    
  April 9, 2021, by the following vote: Yeas 31, Nays 0; and that the
  Senate concurred in House amendments on May 28, 2021, by the
  following vote: Yeas 31, Nays 0.
  Secretary of the Senate    
         I hereby certify that S.B. No. 790 passed the House, with
  amendments, on May 25, 2021, by the following vote: Yeas 117,
  Nays 26, two present not voting.
  Chief Clerk of the House