Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 564 - CHEMICAL DEPENDENCY TREATMENT FACILITIES
Subchapter C - OPERATIONAL REQUIREMENTS
Section 564.28 - Billing Requirements

Universal Citation: 26 TX Admin Code ยง 564.28

Current through Reg. 49, No. 38; September 20, 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.

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