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IN SB0206
Bill
Status
1/6/2015
Primary Sponsor
Jean Leising
Click for details
AI Summary
Senate Bill 206 Summary
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Amends IC 27-8-11-4.5 to clarify that providers may disclose financial incentives and all treatment options to patients, and insurers cannot penalize providers for making such disclosures.
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Adds new section IC 27-8-11-12 requiring insurers and treating providers to refer insured patients to noncontracted pediatric hospitals when needed services are covered but unavailable from contracted pediatric hospitals.
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Requires insurers to pay noncontracted pediatric hospitals the lesser of: (1) usual, customary, and reasonable charges in the service area, or (2) an amount agreed between insurer and hospital.
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Limits patient financial responsibility to only deductibles, coinsurance, or copayments that would apply at a contracted pediatric hospital; prohibits balance billing for any difference between hospital charges and insurer payment.
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Prohibits insurers from penalizing providers for determining that a patient needs referral to a noncontracted pediatric hospital; applies to contracts entered, renewed, or modified after June 30, 1996.
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Effective July 1, 2015.
Legislative Description
Noncontracted pediatric hospital coverage. Provides for referral of an insured to a pediatric hospital that has not entered into a participating provider agreement with an insurer. Specifies requirements for applicability and payment. Makes a conforming amendment.
Last Action
First Reading: referred to Committee on Health & Provider Services
1/6/2015