Bill Text: TX HB4444 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to consumer protections against surprise billing.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-04-15 - No action taken in committee [HB4444 Detail]
Download: Texas-2019-HB4444-Introduced.html
By: Martinez Fischer | H.B. No. 4444 |
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relating to consumer protections against surprise billing. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter E, Chapter 17, Business & Commerce | ||
Code, is amended by adding Section 17.464 to read as follows: | ||
Sec. 17.464. SURPRISE BILLING. (a) In this section: | ||
(1) "Emergency care" has the meaning assigned by | ||
Section 1301.155. | ||
(2) "Emergency care provider" means a physician, | ||
health care practitioner, facility, or other health care provider | ||
who provides emergency care. | ||
(3) "Facility" has the meaning assigned by Section | ||
324.001, Health and Safety Code. | ||
(4) "Facility-based provider" means a physician or | ||
health care provider who provides health care services to patients | ||
of a health care facility. | ||
(5) "Health care practitioner" means an individual who | ||
is licensed to provide health care services. | ||
(6) "Participating provider" means a physician or | ||
health care provider who has contracted with an eligible plan | ||
administrator to provide services to enrollees. | ||
(7) "Surprise bill" means a bill received by an | ||
insured or enrollee for amounts in addition to the applicable | ||
copayment, coinsurance, and deductible: | ||
(A) for services furnished by an out-of-network | ||
facility-based provider who performed the service at a facility | ||
that is an in-network provider; or | ||
(B) for emergency care services furnished by an | ||
out-of-network provider. | ||
(b) For purposes of Section 17.46(a), the term "false, | ||
misleading, or deceptive acts or practices" includes a | ||
facility-based provider that bills an enrollee receiving health | ||
care services described by Subsection (a)(7), except for the | ||
enrollee's responsibility under the enrollee's health plan, | ||
including an applicable copayment, coinsurance, or deductible. | ||
(c) The consumer protection division may not bring an action | ||
under Section 17.47 for an act or practice described by Subsection | ||
(b) if the bill sent to the enrollee is less than five hundred | ||
dollars. | ||
(d) In an action brought under Section 17.47 to enforce this | ||
section, the consumer protection division may request, and the | ||
trier of fact may award the recovery of: | ||
(1) reasonable attorney's fees and court costs; and | ||
(2) the reasonable expenses incurred by the division | ||
in obtaining any remedy available under Section 17.47, including | ||
the cost of investigation, witness fees, and deposition expenses. | ||
SECTION 2. This Act takes effect September 1, 2019. |