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