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GA HB678
Bill
Status
Engrossed
2/12/2018
Primary Sponsor
Richard Smith
Click for details
AI Summary
- Health care providers must disclose to patients, upon request, which health care plans they participate in and which hospitals they are affiliated with prior to nonemergency services, and must provide estimated costs in writing when they are out-of-network with a patient's plan
- Hospitals must publicly post on their websites a list of standard charges (updated annually), names and links to all contracted health care plans, and contact information for hospital-based physician groups providing anesthesiology, pathology, or radiology services
- Insurers offering out-of-network coverage must disclose to enrollees how out-of-network reimbursement is determined, approximate payment amounts for specific out-of-network services, and tools to estimate anticipated out-of-pocket costs by geographic area or ZIP code
- Initial provider bills must be sent within 90 days of patient discharge or last service provided, and patients have 90 days to negotiate, pay, or initiate arbitration before providers can begin extraordinary collection actions as defined under IRS Section 501(r)
- Patients or persons responsible for payment may initiate binding arbitration by filing with the Insurance Commissioner within the 90-day period, with arbitration costs split equally between the parties; effective date is January 1, 2019
Legislative Description
Insurance; consumer protections regarding health insurance; provisions
Last Action
Senate Read and Referred
2/13/2018
Full Bill Text
No bill text available