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IN HB1145
Bill
Status
1/8/2018
Primary Sponsor
Donna Schaibley
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AI Summary
HB 1145 Summary
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Requires state employee health plans to provide covered individuals with good faith estimates of out-of-pocket costs for prescribed, nonemergency health care services within 3 business days of request, at no charge.
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Mandates provider facilities and practitioners to supply patients with good faith cost estimates within 72 hours of request for nonemergency services, available through internet portals or in verbal/written form.
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Requires provider facilities and practitioners to furnish billing information (procedure names, codes, bundled service details) to patients with third-party insurance within 72 hours to enable insurers to provide cost estimates.
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Obligates all health plans (accident and sickness insurers, health maintenance organizations) to provide insured individuals and enrollees with good faith cost estimates within 3 business days at no charge.
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Requires provider facilities and practitioners to publish payment policies for medically necessary services without third-party coverage on their websites or in visible locations; providers meeting federal 501(r) requirements are deemed compliant.
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Exempts Medicaid recipients from all cost estimate requirements; all estimates are nonbinding and actual costs may vary based on patient medical needs.
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Takes effect July 1, 2018.
Legislative Description
Health insurance coverage and cost information. Requires health care providers and health plans to provide to covered individuals and patients certain information concerning the cost of health care services. Requires health care providers to publish a payment policy for medically necessary health care services not covered by a third party payment source.
Last Action
First reading: referred to Committee on Insurance
1/8/2018