2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle G - Provision of Services in Certain Facilities › Chapter 327 - Disclosure of Prices › Section 327.001. Definitions

Sec. 327.001.  DEFINITIONS.  In this chapter:
(1)  "Ancillary service" means a facility item or service that a facility customarily provides as part of a shoppable service.
(2)  "Chargemaster" means the list of all facility items or services maintained by a facility for which the facility has established a charge.
(3)  "Commission" means the Health and Human Services Commission.
(4)  "De-identified maximum negotiated charge" means the highest charge that a facility has negotiated with all third party payors for a facility item or service.
(5)  "De-identified minimum negotiated charge" means the lowest charge that a facility has negotiated with all third party payors for a facility item or service.
(6)  "Discounted cash price" means the charge that applies to an individual who pays cash, or a cash equivalent, for a facility item or service.
(7)  "Facility" means a hospital licensed under Chapter 241.
(8)  "Facility items or services" means all items and services, including individual items and services and service packages, that may be provided by a facility to a patient in connection with an inpatient admission or an outpatient department visit, as applicable, for which the facility has established a standard charge, including:
(A)  supplies and procedures;
(B)  room and board;
(C)  use of the facility and other areas, the charges for which are generally referred to as facility fees;
(D)  services of physicians and non-physician practitioners, employed by the facility, the charges for which are generally referred to as professional charges; and
(E)  any other item or service for which a facility has established a standard charge.
(9)  "Gross charge" means the charge for a facility item or service that is reflected on a facility's chargemaster, absent any discounts.
(10)  "Machine-readable format" means a digital representation of information in a file that can be imported or read into a computer system for further processing.  The term includes.XML,.JSON, and.CSV formats.
(11)  "Payor-specific negotiated charge" means the charge that a facility has negotiated with a third party payor for a facility item or service.
(12)  "Service package" means an aggregation of individual facility items or services into a single service with a single charge.
(13)  "Shoppable service" means a service that may be scheduled by a health care consumer in advance.
(14)  "Standard charge" means the regular rate established by the facility for a facility item or service provided to a specific group of paying patients.  The term includes all of the following, as defined under this section:
(A)  the gross charge;
(B)  the payor-specific negotiated charge;
(C)  the de-identified minimum negotiated charge;
(D)  the de-identified maximum negotiated charge; and
(E)  the discounted cash price.
(15)  "Third party payor" means an entity that is, by statute, contract, or agreement, legally responsible for payment of a claim for a facility item or service.
Added by Acts 2021, 87th Leg., R.S., Ch. 1044 (S.B. 1137), Sec. 1, eff. September 1, 2021.