Out-of-network Provider Reimbursement Rate
| Type | Bill |
|---|---|
| Session | 2020 Regular Session |
| Subjects |
Concerning a correction to the rate of reimbursement that an out-of-network health care provider is entitled to receive from a health insurance carrier for services provided to a covered person at an in-network facility when the health care provider submits a claim to the carrier within the specified time period to conform with existing law.
Bill Summary:
The act corrects the reimbursement rate specified in law that a health insurance carrier is required to reimburse an out-of-network health care provider who provides either emergency services to a covered person or covered nonemergency services to a covered person at an in-network facility so that the law accurately states the reimbursement rate as the greater of:
- 110% of the carrier's median in-network rate of reimbursement; or
- The sixtieth percentile of the in-network rate of reimbursement for the same service in the same geographic area for the prior year based on claims from the all-payer health claims database.
(Note: This summary applies to this bill as enacted.)
Related Documents & Information
| Activity | Vote | Documents |
|---|---|---|
| Refer Senate Bill 20-043 to the Committee of the Whole. | The motion passed on a vote of 10-0. | Vote summary |
| Activity | Vote | Documents |
|---|---|---|
| Refer Senate Bill 20-043 to the Committee of the Whole and with a recommendation that it be placed on the consent calendar. | The motion passed on a vote of 5-0. | Vote summary |
| Date | Calendar | Motion | Vote | Vote Document |
|---|---|---|---|---|
| 02/27/2020 | Third Reading | BILL |
63
AYE
1
NO
1
OTHER
|
Vote record |
| Date | Calendar | Motion | Vote | Vote Document |
|---|---|---|---|---|
| 02/04/2020 | Third Reading | BILL |
30
AYE
1
NO
4
OTHER
|
Vote record |
| Date | Location | Action |
|---|---|---|
| 03/11/2020 | Governor | Governor Signed |
| 03/04/2020 | Governor | Sent to the Governor |
| 03/04/2020 | House | Signed by the Speaker of the House |
| 03/03/2020 | Senate | Signed by the President of the Senate |
| 02/27/2020 | House | House Third Reading Passed - No Amendments |
| 02/24/2020 | House | House Third Reading Laid Over Daily - No Amendments |
| 02/21/2020 | House | House Second Reading Special Order - Passed - No Amendments |
| 02/18/2020 | House | House Committee on Health & Insurance Refer Unamended to House Committee of the Whole |
| 02/06/2020 | House | Introduced In House - Assigned to Health & Insurance |
| 02/04/2020 | Senate | Senate Third Reading Passed - No Amendments |
| 02/03/2020 | Senate | Senate Second Reading Passed - No Amendments |
| 01/29/2020 | Senate | Senate Committee on Health & Human Services Refer Unamended - Consent Calendar to Senate Committee of the Whole |
| 01/08/2020 | Senate | Introduced In Senate - Assigned to Health & Human Services |
Prime Sponsor
Sponsor
| Effective Date | Chapter # | Title | Documents |
|---|---|---|---|
| 03/11/2020 | 21 | Out-of-network Provider Reimbursement Rate |