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GA HB799
Bill
Status
Introduced
1/31/2018
Primary Sponsor
Sharon Cooper
Click for details
AI Summary
- Out-of-network hospitals are prohibited from billing enrollees of health benefit plans for post-stabilization care beyond applicable copayments, coinsurance, and deductibles
- Out-of-network hospitals must, after stabilizing an emergency patient, attempt to obtain and document the patient's health benefit plan information and contact the plan for authorization before providing post-stabilization care
- Health benefit plans contacted by an out-of-network hospital must respond within 6 hours by either authorizing post-stabilization care or arranging a prompt transfer to an in-network hospital; failure to respond within 6 hours or to complete a transfer within 12 hours results in post-stabilization care being deemed authorized, with the plan responsible for payment
- When a health benefit plan arranges a transfer to an in-network hospital, the plan must pay for all medically necessary care rendered prior to the transfer, cover the cost of the transfer, and make all transfer arrangements
- If a patient or their spouse/legal guardian declines the transfer, the out-of-network hospital must promptly provide verbal notice that the patient may be financially responsible for any further post-stabilization care
Legislative Description
Insurance; certain requirements for out of network hospitals prior to post-stabilization care; provide
Last Action
House Second Readers
2/5/2018
Full Bill Text
No bill text available