Presentation To The House Insurance Committee: Senate Bill 1137 .

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Presentation to theHouse InsuranceCommittee:Senate Bill 1137ImplementationStephen PahlDeputy Executive Commissioner,Regulatory ServicesMay 17, 2022

Senate Bill 1137Senate Bill (SB) 1137 added Health andSafety Code (HSC) Chapter 327, whichrequires a hospital licensed under HSCChapter 241 to prominently display a list ordedicated link to a list of all standardcharges for hospital items and shoppableservices on the home page of the hospital'swebsite.SB 1137 took effect on September 1, 2021.2

SB 1137: Standard ChargesSB 1137 requires general and special hospitals tomaintain a list of standard charges, also known as achargemaster, that includes all facility items orservices maintained by a facility for which thefacility has established a charge. The list must: Reflect the standard charges applicable to thatlocation of the facility, regardless of whether thefacility operates in more than one location oroperates under the same license as anotherfacility; Include applicable charges for services providedin both an inpatient and outpatient settings; Be free of charge, publicly accessible, andsearchable; and Be updated annually.3

SB 1137: Shoppable ServicesSB 1137 requires hospitals to make publicly availablea consumer-friendly list of shoppable services,which are services provided by the hospital that aconsumer can schedule in advance. The list must: Have a plain language description of the service, theapplicable charges, and billing codes; Include at least 300 shoppable services, which mustinclude the 70 services specified as shoppable servicesby the Centers for Medicare and Medicaid Service(CMS); Prioritize the selection of services that are among theservices most frequently provided; State each location at which the facility provides theshoppable service and whether the standard chargesincluded in the list apply at that location; and Be free of charge, publicly accessible and searchable by4service description, billing code, and payor.

SB 1137: Price EstimatorIn lieu of providing a list of shoppableservices, a facility may create anInternet-based price estimator that: Provides a cost estimate for each shoppableservice; Allows a person to obtain an estimate ofthe amount the person will be obligated topay the facility if the person elects to usethat facility to provide the service; Is prominently displayed on their website,publicly accessible, and free of charge; and Is accessible without having to register orestablish a user account or password.5

SB 1137: Evaluating ComplianceThe Health and Human ServicesCommission (HHSC) evaluateshospital compliance of SB 1137 by: Investigating complaints made to HHSCregarding noncompliance; Auditing the Internet websites of facilities forcompliance with this chapter; and Confirming that each facility submitted therequired lists.6

SB 1137: Technical Assistance HHSC has posted a complete list of SB 1137requirements on the HHSC public website. HHSC has also created a mailbox wherehospitals can send questions about SB 1137requirements:Hospital Price Transparency@hhs.texas.gov.7

SB 1137: Compliance as ofApril 21, 2022 There are 648 licensed hospitals thatare required to comply with SB 1137. HHSC has received a total of 79hospital submissions and all were inpartial noncompliance. 569 hospitals did not submitinformation to HHSC and areconsidered fully noncompliant.8

SB 1137: Noncompliance TrendsMost Common Noncompliant ItemsPercentof totalDisplayed in a prominent location on or linked from the publicly accessible facilityhomepage (for the Standard List of Charges)HSC §327.003(e)57%De-identified maximum negotiated charge (for the Standard List of Charges)HSC §327.003(c)(2)(C)47%De-identified minimum negotiated charge (for the Standard List of Charges)HSC §327.003(c)(2)(B)47%Payor specific negotiated charge (for the Standard List of Charges)HSC §327.003(c)(2)(E)47%Uses CMS-specified file naming convention (for the Standard List of Charges)HSC §327.003(f)(5)34%Displayed in a prominent location on or linked from the facility homepage(for the Consumer-Friendly List of Shoppable Services)HSC §327.004(e)(1)33%Displayed in a prominent location on or linked from the facility homepage(for the Price Estimator Tool)HSC §327.004(f)(3)(A)28%Allows a person to obtain an estimate of the amount the person will be obligated topay the facility if the person elects to use the facility to provide the service(for the Price Estimator Tool)HSC §327.004(f)(2)27%9

SB 1137: EnforcementSB 1137 authorizes HHSC to impose an administrativepenalty on a hospital if the facility fails to respond toHHSC's request to submit a corrective action plan orfails to comply with the requirements of a correctiveaction plan it submitted. Each day a violation continues is considered aseparate violation. Noncompliant hospitals may be subject to otherenforcement actions under HSC Chapter 241 andChapter 327.10

SB 1137: ImplementationSteps Published an updated guidanceletter to the HHSC website. Updated notifications to hospitalson compliance Adopting rules to implement SB1137.11

House Insurance Committee: Senate Bill 1137 Implementation Stephen Pahl Deputy Executive Commissioner, Regulatory Services. May 17, 2022. Senate Bill 1137. Senate Bill (SB) 1137 added Health and Safety Code (HSC) Chapter 327,which requires a hospital licensed under HSC

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