S 386 - Greater Transparency in Health Care Billing

• Establishes a "benchmark amount" for out-of-network and emergency health care services calculated as the lesser of: 100% of Medicare payment rates, the provider's actual charges, or the median contracted rate in the insurer's network.

• Prohibits health care providers and facilities from billing patients more than the benchmark amount, except when no contracted providers are reasonably available to meet the patient's needs without unreasonable delay.

• Requires health services facilities and providers to provide written disclosures to patients before treatment, emergency services, scheduling procedures, or seeking prior authorization, explaining patient protections regarding non-participating provider costs.

• Makes repeated failure to comply with balance billing restrictions an unfair and deceptive trade practice actionable under Chapter 75 of the General Statutes.

• Effective October 1, 2019, for health care services provided on or after that date.