Committee backs patient-friendly billing bill requiring itemized hospital bills, excludes urgent care

The Medical, Military, Public and Municipal Affairs Committee reported House Bill 4069 favorably as amended, approving a measure that would require hospitals and specified health-care facilities to provide patients with an itemized bill in either physical or electronic format.

Representative Sessions presented the bill and described it as a patient-billing transparency measure that previously passed the House unanimously and stalled in the Senate. Under the bill as amended, patients must be given an itemized bill; they may waive receipt or opt out, and an initial waiver does not prevent a patient from later requesting the itemized bill. Committee members and staff said the amendment is intended to reduce burdens on billing systems and create a universal, minimum standard for itemized bills across facilities.

Representative Bobby Cox and other members asked about enforcement and format. Representative Sessions said the Department of Public Health would serve as an enforcement mechanism and that facilities could not pursue debt collection until they provided the itemized bill or obtained documented proof of a patient’s valid waiver. The bill’s standards include a plain-language description of services, the amount the facility alleges is due, and adjustments or insurance payments; committee discussion described these items as minimum required elements. The amendment removed a 30-day deadline in favor of more flexible timing to accommodate differing billing systems and care pathways; members discussed whether a deadline such as 60 or 90 days might be preferable but did not adopt a new time frame.

Committee staff explained the bill’s definition of “health-care facility” draws from the Certificate of Need (CON) definitions and specifically lists acute care hospitals, psychiatric hospitals, ambulatory surgical facilities and a range of other facility types; staff noted urgent-care or urgent-care-style primary care clinics are not included unless explicitly listed in the health-care facility definition. The bill also carves out nursing homes from certain parts of the definition, per amendment language.

During debate members emphasized the bill is a post-service transparency measure (an itemized bill after care), not a pre-treatment price-estimate or “right-to-shop” law. Representative Holman and others asked about including urgent care; staff and Representative Sessions said the initial measure focuses on “big-ticket” facilities where bills can be life-changing, but representatives said they were open to future amendments to include urgent care if the committee develops a suitable definition.

The committee adopted the amendment by roll call and then reported the bill favorably. The chair announced all members present voted in favor of the amendment and the bill as amended.

Key clarifications from the meeting: the itemized bill must be available in physical or electronic format, patients may opt out but can later request a bill, debt collection is not permitted until facilities comply with the itemized-bill requirement or document an opt-out, urgent care facilities are not included under the current definitions, and the Department of Public Health was identified as an enforcement avenue.

Votes at a glance: Amendment 1 — adopted (favorable roll call); Bill as amended — favorable report (favorable roll call).