HB4054 - Relating to consumer protections against certain medical and health care billing by emergency medical services providers.

  89R9695 DNC-F     By: Spiller H.B. No. 4054       A BILL TO BE ENTITLED   AN ACT   relating to consumer protections against certain medical and health   care billing by emergency medical services providers.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 773.061, Health and Safety Code, is   amended by adding Subsection (a-1) to read as follows:           (a-1)     In addition to other permissible actions or penalties   and regardless of whether an emergency medical services provider is   directly operated by a governmental entity, the department may   revoke, suspend, or refuse to renew a license or certificate of the   provider if the department confirms that the provider has:                 (1)     intentionally submitted incorrect information   required under Section 38.006, Insurance Code; or                 (2)     engaged in a pattern of violations of Section   1271.159, 1275.054, 1301.166, 1551.231, 1575.174, or 1579.112,   Insurance Code.          SECTION 2.  Section 38.006(b), Insurance Code, is amended to   read as follows:          (b)  This section expires September 1, 2027 [ 2025 ].          SECTION 3.  Sections 1271.159(c) and (g), Insurance Code,   are amended to read as follows:          (c)  A political subdivision may annually [ health   maintenance organization shall ] adjust a rate submitted under   Section 38.006 [ payment required by Subsection (b)(1) each plan   year ] by not more than [ increasing the payment by ] the lesser of :                 (1)   the Medicare Ambulance Inflation Factor; [ Index ]   or                 (2)   10 percent of the provider's previous calendar   year rates.          (g)  This section expires September 1, 2027 [ 2025 ].          SECTION 4.  Sections 1275.054(c) and (f), Insurance Code,   are amended to read as follows:          (c)   A political subdivision may annually [ The administrator   shall ] adjust a rate submitted under Section 38.006 [ payment   required by Subsection (b)(1) each plan year ] by not more than   [ increasing the payment by ] the lesser of :                 (1)   the Medicare Ambulance Inflation Factor; [ Index ]   or                 (2)   10 percent of the provider's previous calendar   year rates.          (f)  This section expires September 1, 2027 [ 2025 ].          SECTION 5.  Sections 1301.166(c) and (g), Insurance Code,   are amended to read as follows:          (c)   A political subdivision may annually  [ An insurer shall ]   adjust a rate submitted under Section 38.006 [ payment required by   Subsection (b)(1) each plan year ] by not more than [ increasing the   payment by ] the lesser of :                 (1)   the Medicare Ambulance Inflation Factor; [ Index ]   or                 (2)   10 percent of the provider's previous calendar   year rates.          (g)  This section expires September 1, 2027 [ 2025 ].          SECTION 6.  Sections 1551.231(c) and (f), Insurance Code,   are amended to read as follows:          (c)   A political subdivision may annually  [ The administrator   shall ] adjust a rate submitted under Section 38.006 [ payment   required by Subsection (b)(1) each plan year ] by not more than   [ increasing the payment by ] the lesser of :                 (1)   the Medicare Ambulance Inflation Factor; [ Index ]   or                 (2)   10 percent of the provider's previous calendar   year rates.          (f)  This section expires September 1, 2027 [ 2025 ].          SECTION 7.  Sections 1575.174(c) and (f), Insurance Code,   are amended to read as follows:          (c)   A political subdivision may annually  [ The administrator   shall ] adjust a rate submitted under Section 38.006 [ payment   required by Subsection (b)(1) each plan year ] by not more than   [ increasing the payment by ] the lesser of :                 (1)   the Medicare Ambulance Inflation Factor; [ Index ]   or                 (2)   10 percent of the provider's previous calendar   year rates.          (f)  This section expires September 1, 2027 [ 2025 ].          SECTION 8.  Sections 1579.112(c) and (f), Insurance Code,   are amended to read as follows:          (c)   A political subdivision may annually  [ The administrator   shall ] adjust a rate submitted under Section 38.006 [ payment   required by Subsection (b)(1) each plan year ] by not more than   [ increasing the payment by ] the lesser of :                 (1)   the Medicare Ambulance Inflation Factor; [ Index ]   or                 (2)   10 percent of the provider's previous calendar   year rates.          (f)  This section expires September 1, 2027 [ 2025 ].          SECTION 9.  The changes in law made by this Act apply only to   emergency medical services provided on or after the effective date   of this Act.  Emergency medical services provided before the   effective date of this Act are governed by the law in effect   immediately before the effective date of this Act, and that law is   continued in effect for that purpose.          SECTION 10.  This Act takes effect September 1, 2025.