26 Tex. Admin. Code § 509.67 - Billing Requirements
(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.
Notes
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