- 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.)