AK HB193

Health care insurers must pay non-network providers for emergency services, services at in-network hospitals or ambulatory surgical centers, or services from referrals made without explicit written consent from the covered person.

Non-network provider payments must be the greater of: the median in-network negotiated rate, the 80th percentile of charges adjusted for geography, or at least 350 percent of the Medicare reimbursement rate.

Covered persons may only pay copayments, deductibles, or coinsurance equal to what they would pay for in-network services, with these payments applied toward their in-network deductible.

Non-network providers must bill insurers directly for covered services and cannot balance bill covered persons except for applicable copayments, deductibles, or coinsurance amounts.

Balance billing by health care providers or facilities is made a violation of Alaska's Unfair Trade Practices and Consumer Protection Act, and state group health insurance plans are subject to these requirements.