| (a) This section applies only to a freestanding emergency
medical care (FEMC) facility, as that term is defined by Texas Health
and Safety Code (HSC) §254.001 (relating to Definitions), that
is:
(1) exempt from the licensing requirements of HSC Chapter
254 (relating to Freestanding Emergency Medical Care Facilities) under
HSC §254.052(5), (7), or (8); and
(2) associated with a hospital licensed under HSC Chapter
241 (relating to Hospitals) and this chapter that does not meet the
conditions of participation for certification under Title XVIII of
the Social Security Act (42 U.S.C. §1395 et
seq. ).
(b) This section does not apply to an FEMC facility
associated with a hospital licensed under HSC Chapter 241 and this
chapter that:
(1) has been operating as a hospital for less than
one year;
(2) has submitted an application to a federally recognized
accreditation program for certification under Title XVIII of the Social
Security Act (42 U.S.C. §1395 et seq. );
and
(3) has not failed an accreditation for certification.
(c) 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 FEMC facility is located, as applicable, according
to data collected by the Texas Department of State Health Services
under HSC Chapter 108 (relating to Health Care Data Collection).
(d) In accordance with HSC §241.222 (relating
to Certain Fees Prohibited), an FEMC 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.
(e) In accordance with HSC §241.223 (relating
to Disclosure of Certain Prices and Fees During Declared Disaster;
Construction), an FEMC 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 (relating to Emergency Management),
shall disclose to each patient the prices 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).
(f) In accordance with HSC §241.224 (relating
to Prohibited Pricing Practices During Declared State of Disaster),
during a state of disaster declared by the Governor under Texas Government
Code Chapter 418, an FEMC 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.
(g) Subsection (f)(2) of this section does not prohibit
an FEMC 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.
(h) This section may not be construed as expanding
the type of health care services an FEMC facility is authorized to
provide under HSC Chapter 241 or this chapter.
(i) Pursuant to HSC §241.225 (relating to Enforcement),
and except for good cause shown, the Texas Health and Human Services
Commission shall impose the following applicable penalty on a hospital
licensed under this chapter and HSC Chapter 241 that violates subsection
(f) of this section or HSC §241.224:
(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 hospital's license for 30 days;
and
(3) for the third violation, a permanent revocation
of the hospital's license.
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