| (a) In this section, "unconscionable price"
means a price that is more than 200 percent of the average price for
the same or a substantially similar product or service provided to
other individuals by health care facilities located in the same or
nearest county to the county in which the freestanding emergency medical
care facility is located, as applicable, according to data collected
by the Texas Department of State Health Services under Texas Health
and Safety Code (HSC) Chapter 108 (relating to Health Care Data Collection).
(b) In accordance with HSC §254.160 (relating
to Prohibited Practices During Declared State of Disaster), during
a state of disaster declared by the Governor under Texas Government
Code Chapter 418 (relating to Emergency Management), a facility may
not:
(1) charge an individual an unconscionable price for
a product or service provided at the facility; or
(2) knowingly or intentionally charge a third-party
payor, including a health benefit plan insurer, a price higher than
the price charged to an individual for the same product or service
based on the payor's liability for payment or partial payment of the
product or service.
(c) Subsection (b)(2) of this section does not prohibit
a facility from:
(1) offering an uninsured individual a cash discount
for a particular product or service; or
(2) accepting directly from an individual full payment
for a health care product or service in lieu of submitting a claim
to the individual's health benefit plan.
(d) In accordance with HSC §254.1556 (relating
to Disclosure of Certain Prices and Fees During Declared Disaster;
Construction), a facility that provides testing or vaccination for
an infectious disease for which a state of disaster has been declared
under Texas Government Code Chapter 418, shall disclose the price
the facility charges for the test or vaccine and any facility fees,
supply costs, and other costs associated with the test or vaccine
in accordance with the disclosure requirements described by HSC §254.156
(relating to Disclosure Statement Required).
(e) In accordance with HSC §254.1555 (relating
to Certain Fees Prohibited), a facility that provides a health care
service, including testing or vaccination, to an individual accessing
the service from the individual's vehicle may not charge the individual
or a third-party payor a facility or observation fee.
(f) Pursuant to HSC §254.207 (relating to Enforcement),
and except for good cause shown, the Texas Health and Human Services
Commission shall impose the following applicable penalty on a facility
licensed under this chapter and HSC Chapter 254 (relating to Freestanding
Emergency Medical Care Facilities) that violates subsection (b) of
this section or HSC §254.160:
(1) for the first violation, an administrative penalty
of $10,000;
(2) for the second violation:
(A) an administrative penalty of $50,000; and
(B) a suspension of the facility's license for 30 days;
and
(3) for the third violation, a permanent revocation
of the facility's license.
(g) This section may not be construed as expanding
the type of health care services a facility is authorized to provide
under HSC Chapter 254 or this chapter.
|
