Out-of-network Health Care Disclosures And Charges

The bill:

• Sets the reimbursement rate that a health insurance carrier must pay a health care facility if a covered person is treated for emergency services;
• Requires in-network health care facilities and health care providers to make disclosures to patients covered by a health benefit plan concerning the provision of services by an out-of-network provider;
• Outlines the claims and payment process, including reimbursement rates for the provision of out-of-network services for health care facilities and health care providers; and
• Authorizes arbitration for the payment of health care claims that are in dispute if certain criteria are met.

The commissioner of insurance is required to submit a report annually to the general assembly concerning unanticipated out-of-network services.

(Note: This summary applies to this bill as introduced.)