Bill > HB3150

This bill establishes new regulations for billing practices related to medical equipment and supplies provided to Medicare enrollees in Texas. The legislation defines key terms like "durable medical equipment," "nonparticipating supplier," and "orthotic device" and creates restrictions on how these suppliers can bill Medicare enrollees. Specifically, nonparticipating suppliers are prohibited from charging enrollees more than 115% of the Medicare-approved amount unless the enrollee provides written agreement to pay the additional cost and pays it in full before receiving the equipment. The bill mandates that suppliers provide clear written notice to enrollees about Medicare reimbursement rates and potential out-of-pocket costs. Additionally, the legislation creates a criminal misdemeanor offense for intentional violations, with potential fines ranging from $500 to $1,000, which can be prosecuted in Travis County or other authorized counties. Medicare supplement benefit plan issuers are not required to reimburse amounts exceeding the 115% threshold. The law will apply to medical equipment and supplies sold on or after September 1, 2025, and is designed to protect Medicare enrollees from excessive billing practices by non-participating medical equipment suppliers.

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https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB3150