SB 788 Summary: Medical Price Transparency Act

• Creates the Medical Price Transparency Act requiring health care facilities and physicians to develop written billing policies, establish complaint procedures, and provide cost estimates for elective procedures within 10 business days of request.

• Mandates health care facilities and physicians provide itemized statements to consumers and third-party payors upon request, with facilities refunding overpayments within 30 business days and first two copies free.

• Directs State Department of Health to publish consumer guides on facility and physician pricing practices, including information on how charges vary based on medical condition and factors affecting personal liability.

• Requires health benefit plan issuers to submit aggregate reimbursement rates to the Insurance Department in standardized format and file annual reports covering enrollee satisfaction, quality of care, coverage areas, premiums, and claims payment accuracy.

• Mandates health benefit plans provide written notice to enrollees about potential balance billing from out-of-network providers, provide cost estimates within 10 business days, and identify non-participating providers in network directories; effective November 1, 2017.