SB1330

To charge above 115% without written assignment, the supplier must obtain the enrollee’s written agreement to the additional amount before billing. Also, before receiving the item, the enrollee must enter a rental payment plan or pay the additional amount in full. The agreement must give notice that Medicare will reimburse 80% of the Medicare-approved amount for covered items and that a Medicare supplement insurer need not reimburse the portion above 115%. These are separate timing requirements, not permission to obtain consent after delivery. Final law, section 566.051.

The 80% notice concerns the approved amount, not necessarily the supplier’s full charge. Medicare’s own booklet explains that people generally pay 20% of the approved amount after the Part B deductible, with costs potentially different for suppliers that do not accept assignment. SB1330’s required notice should not be read as a promise that every patient receives reimbursement of 80% of any invoice regardless of coverage or deductible. Official Medicare equipment booklet, pages 8 and 10; Final law.

The Senate committee substitute added the rental-payment-plan alternative; the introduced bill required payment of the extra amount in full before receipt. That change survived the Senate-passed, House committee and final versions, which otherwise match the substitute in substance. The official amendment index lists no separate amendments. Introduced text; Senate substitute; Senate-passed text; House committee text; Text index; Amendment index; Final law.

Compare the published text versions in the official text index. A change is not attributed to a specific amendment here without a verified record.

The law gives affected patients advance notice and agreement requirements, while suppliers must adjust billing and consent procedures. A violation is a false, misleading or deceptive practice under Business & Commerce Code section 17.46. An intentional violation is a misdemeanor punishable by a $500–$1,000 fine; it may be prosecuted in Travis County or another county authorized by criminal-procedure law. The act does not specify jail time for this offense or promise an automatic damages award to every patient. Final law, sections 566.101–566.102.

A separate provision says a Medicare supplement insurer need not reimburse an enrollee or nonparticipating supplier for the portion exceeding 115% of the Medicare-allowed amount. It also preserves insurer-supplier negotiation over the level and type of reimbursement. This is not a requirement that an insurer pay every charge up to 115%, nor a guarantee that a patient’s supplement policy covers the entire remaining balance. Final law, section 1652.059.

The March 11 introduced-bill and March 20 committee-substitute fiscal notes anticipate no significant state or local fiscal impact; state implementation costs could be absorbed with existing resources. They also anticipate no significant impact on correctional populations or correctional resources. Neither note quantifies patient savings or suppliers’ compliance costs, and the act makes no appropriation. Introduced-bill fiscal note; Substitute fiscal note; Final law.