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IN HB1441
Bill
Status
1/15/2019
Primary Sponsor
Carey Hamilton
Click for details
AI Summary
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State employee health plans and accident/sickness insurers must cover and reimburse emergency care without prior authorization, regardless of whether the provider is in-network
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"Emergency" is defined using a "prudent lay person" standard: conditions with symptoms severe enough that an average person would reasonably expect serious health consequences, bodily impairment, or organ dysfunction without immediate care
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Coverage applies only until the patient is stabilized; post-stabilization care is not included under this requirement
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Reimbursement rates are capped at the lesser of usual/customary/reasonable charges in the service area or an amount agreed upon between the plan/insurer and provider
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Providers cannot bill patients beyond applicable copayments, deductibles, or coinsurance for emergency services covered under this law
Legislative Description
Emergency care reimbursement. Requires a state employee health plan and an accident and sickness insurer to cover and reimburse expenses for care obtained by a covered individual in an emergency. Defines "emergency" to include a condition manifesting symptoms with consequences reasonably expected by a prudent lay person to occur without care.
Last Action
Representative Barrett added as coauthor
1/16/2019