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A BILL TO BE ENTITLED
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AN ACT
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relating to consumer protections against certain medical and health |
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care billing by emergency medical services providers. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 773.061, Health and Safety Code, is |
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amended by adding Subsection (a-1) to read as follows: |
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(a-1) In addition to other permissible actions or penalties |
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and regardless of whether an emergency medical services provider is |
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directly operated by a governmental entity, the department may |
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revoke, suspend, or refuse to renew a license or certificate of the |
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provider if the department confirms that the provider has: |
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(1) intentionally submitted incorrect information |
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required under Section 38.006, Insurance Code; or |
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(2) engaged in a pattern of violations of Section |
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1271.159, 1275.054, 1301.166, 1551.231, 1575.174, or 1579.112, |
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Insurance Code. |
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SECTION 2. Section 38.006(b), Insurance Code, is amended to |
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read as follows: |
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(b) This section expires September 1, 2027 [2025]. |
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SECTION 3. Sections 1271.159(c) and (g), Insurance Code, |
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are amended to read as follows: |
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(c) A political subdivision may annually [health |
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maintenance organization shall] adjust a rate submitted under |
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Section 38.006 [payment required by Subsection (b)(1) each plan |
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year] by not more than [increasing the payment by] the lesser of: |
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(1) the Medicare Ambulance Inflation Factor; [Index] |
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or |
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(2) 10 percent of the provider's previous calendar |
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year rates. |
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(g) This section expires September 1, 2027 [2025]. |
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SECTION 4. Sections 1275.054(c) and (f), Insurance Code, |
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are amended to read as follows: |
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(c) A political subdivision may annually [The administrator |
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shall] adjust a rate submitted under Section 38.006 [payment |
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required by Subsection (b)(1) each plan year] by not more than |
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[increasing the payment by] the lesser of: |
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(1) the Medicare Ambulance Inflation Factor; [Index] |
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or |
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(2) 10 percent of the provider's previous calendar |
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year rates. |
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(f) This section expires September 1, 2027 [2025]. |
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SECTION 5. Sections 1301.166(c) and (g), Insurance Code, |
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are amended to read as follows: |
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(c) A political subdivision may annually [An insurer shall] |
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adjust a rate submitted under Section 38.006 [payment required by |
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Subsection (b)(1) each plan year] by not more than [increasing the |
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payment by] the lesser of: |
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(1) the Medicare Ambulance Inflation Factor; [Index] |
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or |
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(2) 10 percent of the provider's previous calendar |
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year rates. |
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(g) This section expires September 1, 2027 [2025]. |
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SECTION 6. Sections 1551.231(c) and (f), Insurance Code, |
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are amended to read as follows: |
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(c) A political subdivision may annually [The administrator |
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shall] adjust a rate submitted under Section 38.006 [payment |
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required by Subsection (b)(1) each plan year] by not more than |
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[increasing the payment by] the lesser of: |
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(1) the Medicare Ambulance Inflation Factor; [Index] |
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or |
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(2) 10 percent of the provider's previous calendar |
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year rates. |
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(f) This section expires September 1, 2027 [2025]. |
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SECTION 7. Sections 1575.174(c) and (f), Insurance Code, |
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are amended to read as follows: |
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(c) A political subdivision may annually [The administrator |
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shall] adjust a rate submitted under Section 38.006 [payment |
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required by Subsection (b)(1) each plan year] by not more than |
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[increasing the payment by] the lesser of: |
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(1) the Medicare Ambulance Inflation Factor; [Index] |
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or |
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(2) 10 percent of the provider's previous calendar |
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year rates. |
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(f) This section expires September 1, 2027 [2025]. |
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SECTION 8. Sections 1579.112(c) and (f), Insurance Code, |
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are amended to read as follows: |
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(c) A political subdivision may annually [The administrator |
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shall] adjust a rate submitted under Section 38.006 [payment |
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required by Subsection (b)(1) each plan year] by not more than |
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[increasing the payment by] the lesser of: |
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(1) the Medicare Ambulance Inflation Factor; [Index] |
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or |
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(2) 10 percent of the provider's previous calendar |
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year rates. |
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(f) This section expires September 1, 2027 [2025]. |
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SECTION 9. The changes in law made by this Act apply only to |
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emergency medical services provided on or after the effective date |
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of this Act. Emergency medical services provided before the |
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effective date of this Act are governed by the law in effect |
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immediately before the effective date of this Act, and that law is |
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continued in effect for that purpose. |
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SECTION 10. This Act takes effect September 1, 2025. |