Tex. Ins. Code § 566.051 · Subchapter B. REGULATION OF CERTAIN BILLING PRACTICES
LIMITATIONS ON BILLING; NOTICE.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A nonparticipating supplier may not charge an enrollee more than 115 percent of the Medicare-approved amount for durable medical equipment, orthotic devices or supplies, or prosthetic devices or supplies covered under Medicare for which the supplier has not accepted written assignment unless:
(1) before the enrollee is billed, the enrollee agrees in writing to pay the additional amount; and
(2) before receiving the durable medical equipment, orthotic device or supply, or prosthetic device or supply, the enrollee:
(A) enters into a rental payment plan; or
(B) pays the additional amount in full.
(b) A written agreement between a nonparticipating supplier and enrollee under this section must provide notice to the enrollee that:
(1) Medicare will reimburse 80 percent of the Medicare-approved amount for durable medical equipment, orthotic devices or supplies, or prosthetic devices or supplies covered under Medicare; and
(2) a Medicare supplement benefit plan issuer is not required to reimburse the nonparticipating supplier or enrollee for the amount by which the charge exceeds 115 percent of the Medicare-approved amount.
Notes and commentary — not statutory text
History
Added by Acts 2025, 89th Leg., R.S., Ch. 1003 (S.B. 1330), Sec. 1, eff. September 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.566.htm
- Text hash
- sha256 b63c44fcfbdf2b826e9819ed618fe6f374919083c7320da0e11d9c69b6af156e
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.