CHAPTER 552. ILLEGAL PRICING PRACTICES - Texas Statutes

INSURANCE CODE

TITLE 5. PROTECTION OF CONSUMER INTERESTS

SUBTITLE C. DECEPTIVE, UNFAIR, AND PROHIBITED PRACTICES

CHAPTER 552. ILLEGAL PRICING PRACTICES

Sec. 552.001. APPLICABILITY OF CHAPTER. (a) This chapter does

not apply to the provision of a health care service to a:

(1) Medicaid or Medicare patient or a patient who is covered by

a federal, state, or local government-sponsored indigent health

care program;

(2) financially or medically indigent person who qualifies for

indigent health care services based on:

(A) a sliding fee scale; or

(B) a written charity care policy established by a health care

provider; or

(3) person who is not covered by a health insurance policy or

other health benefit plan that provides benefits for the services

and qualifies for services for the uninsured based on a written

policy established by a health care provider.

(b) This chapter does not permit the establishment of health

care provider policies or contracts that violate any other state

or federal law.

(c) This chapter does not prohibit a health care provider from

entering into a contract to provide services covered by a health

insurance policy or other health benefit plan with:

(1) the issuer of the health insurance policy or other health

benefit plan; or

(2) a preferred provider organization that contracts with the

issuer of the health insurance policy or other health benefit

plan.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1,

2005.

Amended by:

Acts 2005, 79th Leg., Ch.

724, Sec. 1, eff. June 17, 2005.

Sec. 552.002. FRAUDULENT INSURANCE ACT. An offense under

Section 552.003 is a fraudulent insurance act under Chapter 701.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1,

2005.

Sec. 552.003. CHARGING DIFFERENT PRICES; OFFENSE. (a) A person

commits an offense if:

(1) the person knowingly or intentionally charges two different

prices for providing the same product or service; and

(2) the higher price charged is based on the fact that an

insurer will pay all or part of the price of the product or

service.

(b) An offense under this section is a Class B misdemeanor.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1,

2005.