MA H4619

Restricts facility fees to services provided on hospital campuses (within 250 yards of main buildings), at licensed emergency departments, or for emergency services at satellite emergency facilities, with fines up to $1,000 per violation

Requires health care providers to give patients written notice of facility fees at least 3 days after scheduling appointments (for appointments 10+ days out), and mandates facilities charging such fees to clearly identify their hospital affiliation in signage, marketing, and websites

Prohibits out-of-network providers from billing insured patients more than in-network cost-sharing amounts (copays, coinsurance, deductibles) for unforeseen out-of-network services, including emergency care, services at in-network facilities by out-of-network providers, and ambulance services

Requires insurance carriers to reimburse out-of-network providers at the carrier's median contracted rate for unforeseen out-of-network services, with this payment constituting full payment

Mandates carriers reimburse evaluation and management services at off-campus hospital outpatient facilities at rates equivalent to Medicare's non-facility physician office rates for services identified by the Health Policy Commission