{"data":{"id":"us-tx/tex.-insurance-code-566.051","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 566.051","heading":"LIMITATIONS ON BILLING; NOTICE.","body":"(a) A nonparticipating supplier may not charge an enrollee more than 115 percent of the Medicare-approved amount for durable medical equipment, orthotic devices or supplies, or prosthetic devices or supplies covered under Medicare for which the supplier has not accepted written assignment unless:\n(1) before the enrollee is billed, the enrollee agrees in writing to pay the additional amount; and\n(2) before receiving the durable medical equipment, orthotic device or supply, or prosthetic device or supply, the enrollee:\n(A) enters into a rental payment plan; or\n(B) pays the additional amount in full.\n(b) A written agreement between a nonparticipating supplier and enrollee under this section must provide notice to the enrollee that:\n(1) Medicare will reimburse 80 percent of the Medicare-approved amount for durable medical equipment, orthotic devices or supplies, or prosthetic devices or supplies covered under Medicare; and\n(2) a Medicare supplement benefit plan issuer is not required to reimburse the nonparticipating supplier or enrollee for the amount by which the charge exceeds 115 percent of the Medicare-approved amount.\nAdded by Acts 2025, 89th Leg., R.S., Ch. 1003 (S.B. 1330), Sec. 1, eff. September 1, 2025.","path":["INSURANCE CODE","TITLE 5. PROTECTION OF CONSUMER INTERESTS","SUBTITLE C. DECEPTIVE, UNFAIR, AND PROHIBITED PRACTICES","CHAPTER 566. BILLING FOR CERTAIN MEDICAL EQUIPMENT, DEVICES, AND SUPPLIES","SUBCHAPTER B. REGULATION OF CERTAIN BILLING PRACTICES"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.566.htm#566.051","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"9dbb769122f4d264d711894d8d007cec16464d72f214d37fdb6cd2fd9fd92aaa","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-566.001","next":"us-tx/tex.-insurance-code-566.101"},"notice":"GroundRules: Original legal text. Not legal advice."}