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A BILL TO BE ENTITLED
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AN ACT
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relating to price estimates and billing requirements for certain |
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health care facilities. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 324.001, Health and Safety Code, is |
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amended by adding Subdivision (5-a) to read as follows: |
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(5-a) "Estimate" means a written statement outlining a |
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consumer's total expected billed charges for a nonemergency |
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elective medical service or procedure. |
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SECTION 2. Section 324.101, Health and Safety Code, is |
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amended by amending Subsections (d) and (g) and adding Subsection |
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(d-1) to read as follows: |
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(d) A consumer is entitled to receive and a [The] facility |
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shall provide to a consumer an estimate of the facility's billed |
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charges for any elective inpatient admission or nonemergency |
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outpatient surgical procedure or other service on the consumer's |
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request and before the scheduling of the admission, [or] procedure, |
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or service. Not later than five business days after receiving a |
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request for an estimate under this subsection, the facility shall |
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provide the [The] estimate to the requesting consumer by e-mail |
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[must be provided not later than the 10th business day after the |
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date on which the estimate is requested]. The facility must advise |
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the consumer that: |
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(1) the request for an estimate of billed charges may |
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result in a delay in the scheduling and provision of the inpatient |
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admission, outpatient surgical procedure, or other service; |
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(2) the actual charges for an inpatient admission, |
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outpatient surgical procedure, or other service will vary based on |
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the person's medical condition and other factors associated with |
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performance of the procedure or service; |
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(3) the actual charges for an inpatient admission, |
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outpatient surgical procedure, or other service may differ from the |
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amount to be paid by the consumer or the consumer's third-party |
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payor; |
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(4) the consumer may be personally liable for payment |
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for the inpatient admission, outpatient surgical procedure, or |
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other service depending on the consumer's health benefit plan |
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coverage; and |
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(5) the consumer should contact the consumer's health |
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benefit plan for accurate information regarding the plan structure, |
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benefit coverage, deductibles, copayments, coinsurance, and other |
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plan provisions that may impact the consumer's liability for |
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payment for the inpatient admission, outpatient surgical |
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procedure, or other service. |
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(d-1) A facility shall include in the estimate provided |
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under Subsection (a) information regarding the manner in which an |
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eligible consumer may dispute final billed charges that exceed the |
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amount specified in the estimate by $400 or more, as provided by 45 |
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C.F.R. Section 149.620. |
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(g) A facility that violates [in violation of] this section: |
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(1) may not: |
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(A) take or facilitate the taking of any |
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third-party collection action against a consumer; |
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(B) report the consumer to a credit bureau; or |
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(C) pursue an action against the consumer; and |
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(2) is subject to an enforcement action by the |
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appropriate licensing agency. |
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SECTION 3. Subchapter B, Chapter 324, Health and Safety |
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Code, is repealed. |
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SECTION 4. The changes in law made to Chapter 324, Health |
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and Safety Code, apply only to a request for an estimate made on or |
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after the effective date of this Act. A request for an estimate |
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made before the effective date of this Act is governed by the law in |
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effect at the time the request was made, and the former law is |
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continued in effect for that purpose. |
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SECTION 5. This Act takes effect September 1, 2025. |