HPH: Consideration of HB1490 on March 17, 2021 (87-R)

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HB 1490 – Dean, relating to notice of the cash price of certain health care services by certain hospitals. The bill would amend the Health and Safety Code to require certain hospitals to disclose the hospital’s cash price for each health care service regularly provided by the hospital.

According to the Health and Human Services Commission, no significant fiscal impact to the state is anticipated. Neither the University of Texas System nor the Texas Tech University System anticipate a fiscal impact to their systems.

The City of Houston anticipates no fiscal impact to the city. No significant fiscal implication to other units of local government is anticipated.

The LBB Fiscal Note states no significant fiscal implication to the State is anticipated.

Representative Dean explained the bill. He stated the bill requires hospitals to post the cash prices on their website or upon request. Federal rules already provide for this, but if federal rules go away this would guarantee the price information is available to the patient.

Public Testimony

Cameron Duncan, Texas Hospital Association, testified on the bill. They had some preliminary concerns and stated that Rep. Dean has been working with them. THA supports informed decision-making. Some hospitals have real-time estimator tools already. Their concern is that some hospitals may not have a cash price specific to different services and they would like to ensure that hospitals are not required to post information on services for which they do not have a set price. There were also EMTALA concerns.

The Emergency Medical Treatment and Active Labor Act (EMTALA) is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospital Emergency Departments that accept payments from Medicare to provide an appropriate medical screening examination (MSE) to anyone seeking treatment for a medical condition, regardless of citizenshiplegal status, or ability to pay. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.

EMTALA applies to “participating hospitals.” The statute defines participating hospitals as those that accept payment from the Department of Health and Human ServicesCenters for Medicare and Medicaid Services (CMS) under the Medicare program. Because there are very few hospitals that do not accept Medicare, the law applies to nearly all hospitals. The combined payments of Medicare and Medicaid, $602 billion in 2004, or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA’s provisions apply to all patients, not just to Medicare patients.

The cost of emergency care required by EMTALA is not directly covered by the federal government, so it has been characterized as an unfunded mandate. Uncompensated care represents 6% of total hospital costs.

Source: Wikipedia

The Bill was left pending.



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