HBA-RBT, RBT H.B. 213 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 213
By: Hochberg
Civil Practices
2/25/1999
Introduced



BACKGROUND AND PURPOSE 

Some insurance companies will only pay medical bills within predetermined
time limits.  However, medical providers do not always bill the insurance
company within the insurance company's time limits.  Consequently, patients
are receiving bills that the insurance company refuses to pay because the
insurance company maintains the provider did not submit the claim within
the specified amount of time.  H.B. 213 limits the amount that a health
care provider may recover from a patient to what the patient would have
paid if the bill had been sent on time. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Title 6, Civil Practice and Remedies Code, by adding
Chapter 146, as follows: 

CHAPTER 146.  CERTAIN CLAIMS BY HEALTH CARE SERVICE PROVIDERS BARRED

Sec.  146.001.  DEFINITION.  Defines "health benefit plan" and "health care
service provider." 

Sec.  146.002.  TIMELY PATIENT BILLING REQUIRED.  Requires a health care
service provider to bill a responsible party on or before the first day of
the 11th month after the date services are rendered.  Provides that the
date of billing is the date on which the bill is mailed to the address of
the patient or responsible person. 

Sec.  146.003.  CERTAIN CLAIMS BARRED.  Prohibits a health care service
provider who violates Section 146.002 from recovering from a patient or any
other responsible person any amount which the patient would have been
entitled to receive under a health benefit plan had the provider complied
with Section 146.002. 

SECTION 2.  Effective date: September 1, 1999.

SECTION 3.  Makes application of this Act prospective.

SECTION 4.  Emergency clause.