S.B. No. 2038
 
 
 
 
AN ACT
  relating to prices and fees charged by certain freestanding
  emergency medical care facilities, including prices and fees
  charged during a declared state of disaster; providing
  administrative penalties.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 241, Health and Safety Code, is amended
  by adding Subchapter I-1 to read as follows:
  SUBCHAPTER I-1. PRICES AND FEES CHARGED BY FREESTANDING EMERGENCY
  MEDICAL CARE FACILITIES ASSOCIATED WITH CERTAIN HOSPITALS
         Sec. 241.221.  APPLICABILITY. (a) This subchapter applies
  only to a freestanding emergency medical care facility, as that
  term is defined by Section 254.001, that is:
               (1)  exempt from the licensing requirements of Chapter
  254 under Section 254.052(5), (7), or (8); and
               (2)  associated with a hospital licensed under this
  chapter that does not meet the conditions of participation for
  certification under Title XVIII of the Social Security Act (42
  U.S.C. Section 1395 et seq.).
         (b)  This subchapter does not apply to a freestanding
  emergency medical care facility associated with a hospital licensed
  under this chapter that:
               (1)  has been operating as a hospital for less than one
  year;
               (2)  has submitted an application to a federally
  recognized accreditation program for certification under Title
  XVIII of the Social Security Act (42 U.S.C. Section 1395 et seq.);
  and
               (3)  has not failed an accreditation for certification.
         Sec. 241.222.  CERTAIN FEES PROHIBITED.  (a)  A facility
  described by Section 241.221 that provides a health care service,
  including testing or vaccination, to an individual accessing the
  service from the individual's vehicle may not charge the individual
  or a third-party payor a facility or observation fee.
         (b)  This section may not be construed as expanding the type
  of health care services a facility described by Section 241.221 is
  authorized to provide.
         Sec. 241.223.  DISCLOSURE OF CERTAIN PRICES AND FEES DURING
  DECLARED DISASTER; CONSTRUCTION. (a) A facility described by
  Section 241.221 that provides testing or vaccination for an
  infectious disease for which a state of disaster has been declared
  under Chapter 418, Government Code, shall disclose to each patient
  the prices the facility charges for the test or vaccine and any
  facility fees, supply costs, and other costs associated with the
  test or vaccine in accordance with the disclosure requirements
  described by Section 254.156, as added by Chapter 1093 (H.B. 2041),
  Acts of the 86th Legislature, Regular Session, 2019.
         (b)  This section may not be construed as expanding the type
  of health care services a facility described by Section 241.221 is
  authorized to provide.
         Sec. 241.224.  PROHIBITED PRICING PRACTICES DURING DECLARED
  STATE OF DISASTER. (a) In this section, "unconscionable price"
  means a price that is more than 200 percent of the average price for
  the same or a substantially similar product or service provided to
  other individuals by health care facilities located in the same
  county or nearest county to the county in which the facility
  described by Section 241.221 is located, as applicable, according
  to data collected by the department under Chapter 108.
         (b)  During a state of disaster declared by the governor
  under Chapter 418, Government Code, a facility described by Section
  241.221 may not:
               (1)  charge an individual an unconscionable price for a
  product or service provided at the facility; or
               (2)  knowingly or intentionally charge a third-party
  payor, including a health benefit plan insurer, a price higher than
  the price charged to an individual for the same product or service
  based on the payor's liability for payment or partial payment of the
  product or service.
         (c)  Subsection (b)(2) does not prohibit a facility
  described by Section 241.221 from:
               (1)  offering an uninsured individual a cash discount
  for a particular product or service; or
               (2)  accepting directly from an individual full payment
  for a health care product or service in lieu of submitting a claim
  to the individual's health benefit plan.
         Sec. 241.225.  ENFORCEMENT. Notwithstanding any
  conflicting provision in this subchapter and except for good cause
  shown, the commission shall impose the following penalty on a
  person licensed under this chapter who violates Section 241.224 or
  a rule adopted under that section:
               (1)  for the first violation, an administrative penalty
  in an amount equal to $10,000;
               (2)  for the second violation:
                     (A)  an administrative penalty in an amount equal
  to $50,000; and
                     (B)  a suspension of the person's license for 30
  days; and
               (3)  for the third violation, a permanent revocation of
  the person's license.
         SECTION 2.  Subchapter D, Chapter 254, Health and Safety
  Code, is amended by adding Sections 254.1555 and 254.1556 to read as
  follows:
         Sec. 254.1555.  CERTAIN FEES PROHIBITED.  (a)  A facility
  that provides a health care service, including testing or
  vaccination, to an individual accessing the service from the
  individual's vehicle may not charge the individual or a third-party
  payor a facility or observation fee.
         (b)  This section may not be construed as expanding the type
  of health care services a facility is authorized to provide under
  this chapter.
         Sec. 254.1556.  DISCLOSURE OF CERTAIN PRICES AND FEES DURING
  DECLARED DISASTER; CONSTRUCTION. (a) A facility that provides
  testing or vaccination for an infectious disease for which a state
  of disaster has been declared under Chapter 418, Government Code,
  shall disclose the price the facility charges for the test or
  vaccine and any facility fees, supply costs, and other costs
  associated with the test or vaccine in accordance with the
  disclosure requirements described by Section 254.156, as added by
  Chapter 1093 (H.B. 2041), Acts of the 86th Legislature, Regular
  Session, 2019.
         (b)  This section may not be construed as expanding the type
  of health care services a facility is authorized to provide under
  this chapter.
         SECTION 3.  Subchapter D, Chapter 254, Health and Safety
  Code, is amended by adding Section 254.160 to read as follows:
         Sec. 254.160.  PROHIBITED PRICING PRACTICES DURING DECLARED
  STATE OF DISASTER. (a) In this section, "unconscionable price"
  means a price that is more than 200 percent of the average price for
  the same or a substantially similar product or service provided to
  other individuals by health care facilities located in the same
  county or nearest county to the county in which the freestanding
  emergency medical care facility is located, as applicable,
  according to data collected by the department under Chapter 108.
         (b)  During a state of disaster declared by the governor
  under Chapter 418, Government Code, a facility may not:
               (1)  charge an individual an unconscionable price for a
  product or service provided at the facility; or
               (2)  knowingly or intentionally charge a third-party
  payor, including a health benefit plan insurer, a price higher than
  the price charged to an individual for the same product or service
  based on the payor's liability for payment or partial payment of the
  product or service.
         (c)  Subsection (b)(2) does not prohibit a facility from:
               (1)  offering an uninsured individual a cash discount
  for a particular product or service; or
               (2)  accepting directly from an individual full payment
  for a health care product or service in lieu of submitting a claim
  to the individual's health benefit plan.
         SECTION 4.  Subchapter E, Chapter 254, Health and Safety
  Code, is amended by adding Section 254.207 to read as follows:
         Sec. 254.207.  ENFORCEMENT. Notwithstanding any
  conflicting provision in this subchapter and except for good cause
  shown, the Health and Human Services Commission shall impose the
  following on a person licensed under this chapter who violates
  Section 254.160 or a rule adopted under that section:
               (1)  for the first violation, an administrative penalty
  in an amount equal to $10,000;
               (2)  for the second violation:
                     (A)  an administrative penalty in an amount equal
  to $50,000; and
                     (B)  a suspension of the person's license for 30
  days; and
               (3)  for the third violation, a permanent revocation of
  the person's license.
         SECTION 5.  This Act takes effect September 1, 2021.
 
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 2038 passed the Senate on
  April 19, 2021, by the following vote:  Yeas 31, Nays 0;             
  May 27, 2021, Senate refused to concur in House amendments and
  requested appointment of Conference Committee; May 28, 2021, House
  granted request of the Senate; May 30, 2021, Senate adopted
  Conference Committee Report by the following vote:  Yeas 30,
  Nays 1.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 2038 passed the House, with
  amendments, on May 25, 2021, by the following vote:  Yeas 127,
  Nays 18, two present not voting; May 28, 2021, House granted
  request of the Senate for appointment of Conference Committee;             
  May 30, 2021, House adopted Conference Committee Report by the
  following vote:  Yeas 127, Nays 14, two present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
             Date
 
 
  ______________________________ 
            Governor