HB1314 - Relating to price estimates and billing requirements for certain health care facilities.

      H.B. No. 1314         AN ACT   relating to price estimates and billing requirements for certain   health care facilities.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 324.001, Health and Safety Code, is   amended by adding Subdivision (5-a) to read as follows:                 (5-a)     "Estimate" means a written statement outlining a   consumer's total expected billed charges for a nonemergency   elective medical service or procedure.          SECTION 2.  Section 324.101, Health and Safety Code, is   amended by amending Subsections (d) and (g) and adding Subsection   (d-1) to read as follows:          (d)   A consumer is entitled to receive and a  [ The ] facility   shall provide to a consumer  an estimate of the facility's billed     charges for any elective inpatient admission or nonemergency   outpatient surgical procedure or other service on the consumer's     request and before the scheduling of the admission , [ or ] procedure ,   or service.   Not later than five business days after receiving a   request for an estimate under this subsection, the facility shall   provide the  [ The ] estimate to the requesting consumer by e-mail   [ must be provided not later than the 10th business day after the   date on which the estimate is requested ].  The facility must advise   the consumer that:                (1)  the request for an estimate of billed charges may   result in a delay in the scheduling and provision of the inpatient   admission, outpatient surgical procedure, or other service;                (2)  the actual charges for an inpatient admission,   outpatient surgical procedure, or other service will vary based on   the person's medical condition and other factors associated with   performance of the procedure or service;                (3)  the actual charges for an inpatient admission,   outpatient surgical procedure, or other service may differ from the   amount to be paid by the consumer or the consumer's third-party   payor;                (4)  the consumer may be personally liable for payment   for the inpatient admission, outpatient surgical procedure, or   other service depending on the consumer's health benefit plan   coverage; and                (5)  the consumer should contact the consumer's health   benefit plan for accurate information regarding the plan structure,   benefit coverage, deductibles, copayments, coinsurance, and other   plan provisions that may impact the consumer's liability for   payment for the inpatient admission, outpatient surgical   procedure, or other service.           (d-1)     A facility shall include in the estimate provided   under Subsection (d) information regarding the manner in which an   eligible consumer may dispute final billed charges that exceed the   amount specified in the estimate by $400 or more, as provided by 45   C.F.R. Section 149.620.          (g)  A facility that violates [ in violation of ] this section :                 (1)  may not:                       (A)     take or facilitate the taking of any   third-party collection action against a consumer;                       (B)  report the consumer to a credit bureau; or                       (C)  pursue an action against the consumer; and                 (2)   is subject to an enforcement action by the   appropriate licensing agency.          SECTION 3.  Subchapter B, Chapter 324, Health and Safety   Code, is repealed.          SECTION 4.  The changes in law made to Chapter 324, Health   and Safety Code, apply only to a request for an estimate made on or   after the effective date of this Act.  A request for an estimate   made before the effective date of this Act is governed by the law in   effect at the time the request was made, and the former law is   continued in effect for that purpose.          SECTION 5.  This Act takes effect September 1, 2025.       ______________________________ ______________________________      President of the Senate Speaker of the House                   I certify that H.B. No. 1314 was passed by the House on May 2,   2025, by the following vote:  Yeas 133, Nays 0, 1 present, not   voting, and that the House adopted H.C.R. No. 167 authorizing   certain corrections in H.B. No. 1314 on May 28, 2025, by the   following vote: Yeas 119, Nays 0, 1 present, not voting.     ______________________________   Chief Clerk of the House                 I certify that H.B. No. 1314 was passed by the Senate on May   25, 2025, by the following vote:  Yeas 31, Nays 0, and that the   Senate adopted H.C.R. No. 167 authorizing certain corrections in   H.B. No. 1314 on May 29, 2025, by the following vote: Yeas 31, Nays   0.     ______________________________   Secretary of the Senate       APPROVED:  _____________________                      Date                           _____________________                    Governor