HB 495 Summary

• Creates the Health Care Billing Equity Act to protect Idaho residents from unexpected balance billing by out-of-network providers at in-network health care facilities

• Prohibits out-of-network providers from balance billing covered persons for emergency services and requires health plans to reimburse at the greater of 85% of the nearest in-network provider's rate or 145% of the Medicare payment rate

• Prohibits out-of-network providers from balance billing for nonemergency services at in-network facilities, except when the covered person signs a pre-admission written agreement in font at least twice as large as other text disclosing the provider is out-of-network and the patient's financial responsibility