| (a) A facility shall comply with the following balance
billing requirements.
(1) A facility may not violate a law that prohibits
the facility from billing a patient who is an insured, participant,
or enrollee in a managed care plan an amount greater than an applicable
copayment, coinsurance, and deductible under the insured's, participant's,
or enrollee's managed care plan or that imposes a requirement related
to that prohibition.
(2) A facility shall comply with Senate Bill 1264,
86th Legislature, Regular Session, 2019, and with related Texas Department
of Insurance rules at 28 TAC Chapter 21, Subchapter OO, §§21.4901
- 21.4904 (relating to Disclosures by Out-of-Network Providers) to
the extent this subchapter applies to the facility.
(b) A facility shall comply with the itemized bill
requirements under Texas Health and Safety Code §185.002.
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