SB 1602 Summary

• Eliminates arbitration process for surprise out-of-network bills and establishes new protections requiring health insurers to reimburse out-of-network emergency care providers at the highest of: in-network rates, usual and customary rates, or Medicare reimbursement rates.

• Requires non-emergency out-of-network providers to provide written disclosure to patients before treatment that includes provider name, estimated costs, and notice that signing waives dispute resolution rights; bills without proper disclosure qualify as surprise bills.

• Limits enrollee cost-sharing for emergency services rendered by out-of-network providers to the same amount that would apply if an in-network provider rendered the service.

• Prevents health insurers from imposing greater cost-sharing when they fail to inform enrollees that services were rendered by out-of-network providers.

• Repeals the former arbitration dispute resolution sections (20-3114 through 20-3118) and requires the Department of Insurance and Financial Institutions to report on dispute resolution practices by November 1, 2021.