ID H0529

Health carriers are prohibited from preventing health care providers from offering patients a discounted cash price for services instead of filing an insurance claim.

Covered persons who negotiate a price lower than their plan's average allowed amount and pay out of pocket for medically necessary services can have that payment counted toward their deductible and annual maximum out-of-pocket expense.

Providers who accept discounted cash payments must treat them as payment in full and cannot bill patients or insurers for any remaining balance.

Out-of-pocket payments are attributed to in-network or out-of-network deductibles based on the provider's network status, and amounts cannot exceed contractual limits or carry over to new plan periods.

Exemptions include Medicaid, Medicare supplemental policies, workers' compensation, dental/vision-only plans, short-term policies of six months or less, and certain limited benefit policies; effective date is July 1, 2026.