Senate Bill 1731 amends provisions of the Health and Safety Code, Occupations Code, and Insurance Code relating to requirements and procedures for reporting, collecting, and compiling certain health care information and providing consumer access to that information. The bill directs the Department of State Health Services (DSHS) to make available on the department's website a consumer guide to health care that includes information about pricing practices and charge comparisons for certain ambulatory surgical centers, birthing centers, and hospitals. The bill also requires certain health care facilities and physicians to develop, implement, and enforce written billing policies relating to charges, discounts, and third-party payors of health care services and supplies. Among other provisions, facilities are required to provide itemized billing statements to a consumer and a third-party payor on request and to establish and implement procedures for informal resolution of consumer complaints. Physicians are required to provide an estimate of charges, an itemized statement, and a written explanation of charges to certain patients on request. The bill requires health benefit plans and certain facility-based physicians to disclose to plan enrollees and patients information relating to services provided at a health care facility that may not be covered by the plan and for which the enrollee or patient may be financially responsible. The bill also directs the commissioner of insurance to appoint an advisory committee to study the adequacy of health benefit plan facility-based provider networks.

Senate Bill 1731 authorizes DSHS to collect and disseminate health benefit plan reimbursement rate data and requires certain group health benefit plan issuers to submit the data to the department. The bill provides for the data's confidentiality and publication in aggregate form and establishes an administrative penalty for an issuer's failure to submit data as required. In addition, the bill adds new requirements for health maintenance organization and preferred provider benefit plan annual reports to the commissioner of insurance and includes provisions relating to the collection of certain radiological procedure data by the Texas Health Care Information Council.

Senate Bill 1731	Senate Author: Duncan
Effective: 9-1-07	House Sponsor: Isett, Carl et al.