DE HB286

Requires health insurance policies to cover inadvertent out-of-network services at agreed-upon or negotiated rates, alongside existing emergency care coverage.

Defines inadvertent out-of-network services as covered health care provided by out-of-network providers in in-network facilities, when in-network services are unavailable, or laboratory testing ordered by in-network providers but performed by out-of-network laboratories.

Prohibits non-network providers from balance billing insureds when disputes over rates occur; requires arbitration by the Insurance Commissioner to determine appropriate charges.

Requires insurers to pay non-network providers the highest allowable charge from the prior 12 months pending arbitration determination, and establishes an arbitration fee schedule where the non-prevailing party reimburses the Commissioner's expenses.

Directs the Insurance Commissioner to promulgate regulations implementing the Act and ensuring health insurance carriers maintain adequate networks of primary care providers, specialists, and ancillary health care resources.