Engrossed House Bill (S)

Authored by

DIGEST

Out of network health care services. Specifies patient, state and local government employee health plan, and accident and sickness insurer liability for payment for out of network health care services provided: (1) in an emergency; and (2) when non-emergent and the health care services are arranged by, provided in, or referred by an in network provider. Requires the commissioner of insurance to approve and post on the department of insurance Internet web site: (1) at least one independent data base to be used in establishing payments to out of network providers; and (2) a list of mediators to be used Out of network health care services. Specifies patient, state and local government employee health plan, and accident and sickness insurer liability for payment for out of network health care services provided: (1) in an emergency; and (2) when non-emergent and the health care services are arranged by, provided in, or referred by an in network provider. Requires the commissioner of insurance to approve and post on the department of insurance Internet web site: (1) at least one independent data base to be used in establishing payments to out of network providers; and (2) a list of mediators to be used in certain out of network payment disputes between providers and the third party payers. Requires certain notices by the third party payers and out of network providers. Makes conforming amendments. ... View more