Tex. HEALTH & SAFETY Code ch. 185 — HEALTH CARE BILLING | Texas Statutes — Texas

Tex. HEALTH & SAFETY Code § 185.001. DEFINITIONS.

In this chapter: (1) "Debt collection" has the meaning assigned by Section 392.001 , Finance Code. (2) "Health care provider" means a facility licensed, certified, or otherwise authorized to provide health care services or supplies in this state in the ordinary course of business, including a hospital, except the term does not include a federally-qualified health center, as defined by 42 U.S.C. Section 1396d(l)(2)(B). (3) "Health care service" means a service a health care provider provides to an individual to diagnose, prevent, treat, alleviate, cure, or heal a human health condition, illness, injury, or disease. Added by Acts 2023, 88th Leg., R.S., Ch. 271 (S.B. 490 ), Sec. 1, eff. September 1, 2023.

Tex. HEALTH & SAFETY Code § 185.002. ITEMIZED BILL REQUIRED.

(a) A health care provider that requests payment from a patient after providing a health care service or related supply to the patient shall submit with the request a written, itemized bill of the alleged amount due for each service and supply provided to the patient during the patient's visit to the provider. The provider must submit the itemized bill not later than the 30th day after the provider receives a final payment on the provided service or supply from a third party. (b) The itemized bill must include: (1) a plain language description of each distinct health care service or supply the health care provider provided to the patient; (2) if the provider sought or is seeking reimbursement from a third party, any billing code submitted to the third party and the amounts billed to and paid by that third party; and (3) the amount the provider alleges is due from the patient for each service and supply provided to the patient. (c) A health care provider may issue the itemized bill: (1) electronically, including through a patient portal on the provider's Internet website, subject to Subsection (c-1); (2) through a hard copy delivered by mail or a common carrier; or (3) through a hard copy the patient or the patient's designee obtains at the provider's place of business. (c-1) A health care provider that issues an itemized bill to a patient electronically through a patient portal under Subsection (c) shall: (1) determine whether the patient has an active patient profile on the portal, if feasible; and (2) mail, e-mail, or provide a physical copy of the itemized bill to the patient, according to the patient's chosen method of issuance, if the health care provider: (A) determines the patient does not have an active patient portal; or (B) is unable to determine whether the patient has an active patient portal. (d) A patient is entitled to obtain from the health care provider an itemized bill: (1) subject to Subdivision (3), on request after the itemized bill is initially issued under Subsection (a); (2) through the patient's chosen method of issuance in accordance with Subsection (c); and (3) until the date the provider is no longer required to retain an itemized bill under applicable record retention laws or provider policies and procedures regarding retention of patient billing information. (e) A health care provider may not pursue debt collection against a patient for a provided health care service or supply unless the provider has complied with this section. Added by Acts 2023, 88th Leg., R.S., Ch. 271 (S.B. 490 ), Sec. 1, eff. September 1, 2023.

Tex. HEALTH & SAFETY Code § 185.003. DISCIPLINARY ACTION BY LICENSING AUTHORITY.

(a) The appropriate licensing authority shall take disciplinary action against a health care provider that violates this chapter as if the provider violated an applicable licensing law. (b) Subsection (a) does not apply to a health care provider that in good faith mails a hard copy of an itemized bill to a patient if: (1) the mailed copy is returned as undeliverable or lost; or (2) the address on file for the patient was not current at the time the itemized bill was mailed. Added by Acts 2023, 88th Leg., R.S., Ch. 271 (S.B. 490 ), Sec. 1, eff. September 1, 2023.