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Introduced House Bill (H)

DIGEST

Health and insurance matters. Requires the governing board of a nonprofit hospital to hold public semiannual meetings concerning health care services pricing and measures the hospital is taking to make health services more affordable. Provides that a facility is an off-campus location of a hospital if: (1) the operations of the facility are directly or indirectly owned or controlled by, or affiliated with, the hospital; (2) the facility provides services that are organizationally and functionally integrated with the services of the hospital; and (3) the facility provides preventive services, diagnostic services, treatment services, or emergency services. Requires an off-campus location Health and insurance matters. Requires the governing board of a nonprofit hospital to hold public semiannual meetings concerning health care services pricing and measures the hospital is taking to make health services more affordable. Provides that a facility is an off-campus location of a hospital if: (1) the operations of the facility are directly or indirectly owned or controlled by, or affiliated with, the hospital; (2) the facility provides services that are organizationally and functionally integrated with the services of the hospital; and (3) the facility provides preventive services, diagnostic services, treatment services, or emergency services. Requires an off-campus location of a hospital to apply for, obtain, and use on all claims for reimbursement or payment a national provider identifier separate and distinct from the national provider identifier of the hospital of which it is an off-campus location. Requires hospitals and ambulatory surgical outpatient centers to post certain health care services pricing information by billing code on the hospital's Internet web site and sets forth requirements. Requires: (1) a provider facility (including a hospital) in which a nonemergency health care service will be performed; or (2) a practitioner (including a physician) who will perform a nonemergency health care service; upon request from the individual for whom the nonemergency health care service has been ordered, to provide a good faith estimate of the charge for the nonemergency health care service not more than 72 hours after receiving the individual's request. Requires a health carrier (including an insurer or a health maintenance organization) to provide to an individual who is entitled to coverage from the health carrier, not more than 24 hours after the individual requests the information, a good faith estimate of: (1) the amount of the cost of the nonemergency health care service that the health carrier will pay for or reimburse to the covered individual; or (2) the extent and nature of the ordered nonemergency health care service a covered individual is entitled to receive. Requires the department of insurance to submit a request for information and a request for proposal concerning the establishment and implementation of an all payer claims data base and sets forth requirements. Provides that if a health carrier provides coverage to the individual through a network plan, the health carrier shall inform the individual whether the provider facility in which the nonemergency health care service will be provided and the practitioners who will provide the nonemergency health care service are included in the health carrier's network plan. Requires provider facilities and practitioners to post signs in waiting rooms and offices and to provide Internet web site notices about the availability of estimates of the amount the patient will be charged for medical services. Requires health carriers to provide Internet web site notices about the availability of good faith estimates of coverage for nonemergency health care services. Provides penalties for noncompliance by provider facilities, practitioners, and health carriers. Requires an insurance producer to disclose commission information. Prohibits health provider contracts from including provisions that prohibit the disclosure of health care service claims data to employers providing the health coverage and makes a violation an unfair and deceptive act. ... View more