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TITLE 26 - HEALTH AND HUMAN SERVICES
PART 1 - HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 506 - SPECIAL CARE FACILITIES
SUBCHAPTER C - OPERATIONAL REQUIREMENTS
SECTION/RULE §506.37 - Billing Requirements
Chapter Review Date 08/15/2024

(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.

Source Note: The provisions of this §506.37 adopted to be effective April 15, 2021, 46 TexReg 2425; amended to be effective August 18, 2024, 49 TexReg 6218.

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