By:  Bailey                                            H.B. No. 233
       73R1604 KLL-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to cost estimates for procedures and services by hospitals
    1-3  and nursing homes and to reports on the status of health care
    1-4  services.
    1-5        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-6        SECTION 1.  Subchapter A, Chapter 241, Health and Safety
    1-7  Code, is amended by adding Sections 241.006 and 241.007 to read as
    1-8  follows:
    1-9        Sec. 241.006.  COST ESTIMATE.  (a)  The commissioner of
   1-10  health shall require hospitals to publish cost estimates for
   1-11  procedures and services provided by the hospital.
   1-12        (b)  The commissioner shall require hospitals to furnish a
   1-13  written estimate to a prospective patient of the average charges
   1-14  for health services related to a particular diagnostic condition or
   1-15  medical procedure to be provided by the hospital to the prospective
   1-16  patient.
   1-17        (c)  When a hospital provides cost estimates, a request for
   1-18  an estimate by a prospective patient must be in writing and include
   1-19  in the request a written medical diagnosis made by a health care
   1-20  practitioner licensed to provide the diagnosis.   A hospital may
   1-21  require the prospective patient to provide the hospital with
   1-22  information about the prospective patient's age and gender and any
   1-23  other information that will allow the hospital to provide a more
   1-24  accurate estimate.
    2-1        (d)  A hospital shall provide cost estimates of health care
    2-2  services under this section by providing notice to the public that
    2-3  the hospital will provide an estimate of charges for diagnostic
    2-4  conditions or medical procedures.  Notice may be given by posting a
    2-5  statement of the procedure for requesting a cost estimate in a
    2-6  public area of the hospital.
    2-7        (e)  A hospital shall provide cost estimates of health care
    2-8  services under this section by publishing a notice of the service
    2-9  in any advertisement or promotional material of the hospital.
   2-10        Sec. 241.007.  REPORT.  The commissioner of health shall
   2-11  prepare a report regarding the status and operations of hospitals
   2-12  in the state.  The report must be submitted to the governor and
   2-13  legislature not later than February 1 of each odd-numbered year.
   2-14  The report must contain information, analysis, and recommendations
   2-15  concerning:
   2-16              (1)  the status of the health care cost problem,
   2-17  including the costs faced by employers and individuals;
   2-18              (2)  the status of competitive forces in the market for
   2-19  health services, the market for health plans, and the effect of
   2-20  competitive forces on the health care cost problem;
   2-21              (3)  the feasibility and cost-effectiveness of
   2-22  facilitating development of strengthened competitive forces through
   2-23  state initiatives;
   2-24              (4)  the feasibility of limiting health care costs by
   2-25  means other than competitive forces, including direct forms of
   2-26  government intervention, such as price regulation;
   2-27              (5)  the overall status of access to adequate health
    3-1  services by citizens of the state, the scope of financial and
    3-2  geographic barriers to access, the effect of competitive forces on
    3-3  access, and the prospects for access to health care services
    3-4  improving or degenerating; and
    3-5              (6)  the feasibility and cost-effectiveness of
    3-6  enhancing access to adequate health services for citizens of Texas
    3-7  through state initiatives.
    3-8        SECTION 2.  Subchapter A, Chapter 242, Health and Safety
    3-9  Code, is amended by adding Sections 242.015 and 242.016 to read as
   3-10  follows:
   3-11        Sec. 242.015.  COST ESTIMATE.  (a)  The commissioner of
   3-12  health shall require nursing homes to publish cost estimates for
   3-13  procedures and services provided by the nursing home.
   3-14        (b)  The commissioner shall require nursing homes to furnish
   3-15  a written estimate to a prospective patient of the average charges
   3-16  for health services related to a particular diagnostic condition or
   3-17  medical procedure to be provided by the nursing home to the
   3-18  prospective patient.
   3-19        (c)  When a hospital provides cost estimates, a request for
   3-20  an estimate by a prospective patient must be in writing and include
   3-21  in the request a written medical diagnosis made by a health care
   3-22  practitioner licensed to provide the diagnosis.  A nursing home may
   3-23  require the prospective patient to provide the nursing home with
   3-24  information about the prospective patient's age and gender and any
   3-25  other information that will allow the nursing home to provide a
   3-26  more accurate estimate.
   3-27        (d)  A nursing home shall provide cost estimates of health
    4-1  care services under this section by providing notice to the public
    4-2  that the nursing home will provide an estimate of charges for
    4-3  diagnostic conditions or medical procedures.  Notice may be given
    4-4  by posting a statement of the procedure for requesting a cost
    4-5  estimate in a public area of the nursing home.
    4-6        (e)  A nursing home shall provide cost estimates of health
    4-7  care services under this section by publishing a notice of the
    4-8  service in any advertisement or promotional material of the nursing
    4-9  home.
   4-10        Sec. 242.016.  REPORT.  The commissioner of health shall
   4-11  prepare a report regarding the status and operations of nursing
   4-12  homes in the state.  The report must be submitted to the governor
   4-13  and legislature not later than February 1 of each odd-numbered
   4-14  year.  The report must contain information, analysis, and
   4-15  recommendations concerning:
   4-16              (1)  the status of the health care cost problem,
   4-17  including the costs faced by employers and individuals;
   4-18              (2)  the status of competitive forces in the market for
   4-19  health services, the market for health plans, and the effect of
   4-20  competitive forces on the health care cost problem;
   4-21              (3)  the feasibility and cost-effectiveness of
   4-22  facilitating development of strengthened competitive forces through
   4-23  state initiatives;
   4-24              (4)  the feasibility of limiting health care costs by
   4-25  means other than competitive forces, including direct forms of
   4-26  government intervention, such as price regulation;
   4-27              (5)  the overall status of access to adequate health
    5-1  services by citizens of the state, the scope of financial and
    5-2  geographic barriers to access, the effect of competitive forces on
    5-3  access, and the prospects for access to health care services
    5-4  improving or degenerating; and
    5-5              (6)  the feasibility and cost-effectiveness of
    5-6  enhancing access to adequate health services for citizens of Texas
    5-7  through state initiatives.
    5-8        SECTION 3.  This Act takes effect September 1, 1993.
    5-9        SECTION 4.  The importance of this legislation and the
   5-10  crowded condition of the calendars in both houses create an
   5-11  emergency and an imperative public necessity that the
   5-12  constitutional rule requiring bills to be read on three several
   5-13  days in each house be suspended, and this rule is hereby suspended.