House Bill No. 506 - No Surprises Act Summary

• Establishes the "No Surprises Act" as Chapter 66 of Title 41, Idaho Code, to protect health benefit plan members from surprise billing by out-of-network providers at in-network facilities.

• Out-of-network providers must accept the health benefit plan's allowed amount for in-network providers as payment in full for emergency services at in-network facilities, with cost-sharing calculated using in-network benefit design.

• Out-of-network providers must accept in-network allowed amounts for post-emergency inpatient services and nonemergency services at in-network facilities, except when a separate written agreement signed at least 5 calendar days before service is executed with specific cost estimates and disclosures.

• Self-funded health plans governed by the Employee Retirement Income Security Act (ERISA) may voluntarily elect to participate by providing annual notice to the director.

• Violating providers or health benefit plans are liable for the injured party's reasonable attorney's fees and costs; any billing by out-of-network providers in violation is void and unenforceable.