H.F. No. 2311 Summary

• Health plan companies and health care providers must provide patients with explicit, intelligible bills containing descriptive language understandable to the average patient when the patient is responsible for any portion of the bill.

• Health care providers must disclose on patient bills the dollar amount they accept as payment in full, the Medicare-allowable fee-for-service payment rate, and their Medicare percent (percentage of Medicare allowable rate accepted as full payment).

• Health care providers must establish and publicly disclose their Medicare percent through posted notices at reception/check-in areas, on their website, and on payment-related documents requiring patient signatures.

• Providers must obtain signed acknowledgments from patients before service regarding coverage status and network participation; providers cannot bill patients for noncovered services or balance-bill beyond in-network rates without proper disclosure.

• Providers employed by or affiliated with hospitals or clinics cannot be reimbursed at amounts greater than their facility's Medicare percent, and providers failing to provide required disclosure forms face $1,000 fines or reimbursement reductions.