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.