Health insurance; requires health insurer, etc., to calculate amount based on actual charge. (SB964)

Introduced By

Sen. Harry Blevins (R-Chesapeake)

Progress

Introduced
Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law

Description

Health insurance; cost-sharing calculations. Requires a health insurer, health services plan, or health maintenance organization, when calculating the coinsurance obligation or other percentage of the cost of covered services provided to its insured, subscriber, or enrollee, to calculate the amount based on an amount not to exceed the provider's actual charge for the service when (i) the health insurer, health services plan, or health maintenance organization has agreed to pay the provider a fixed rate or charge for the covered service without regard to the provider's actual charge for the service and (ii) the provider's actual charge for the service is less than the fixed rate or charge for the covered service that the insurer, health services plan, or health maintenance organization has agreed to pay to the provider. In addition, persons covered under a managed care health insurance plan shall not be liable to the provider for any amount, other than any required copayment, in excess of the specified percentage of the cost of the covered service that is calculated based upon an amount not to exceed the provider's actual charge for the service provided to the covered person. Currently, a health insurer, health services plan, or health maintenance organization is required to calculate such amount based upon an amount that does not exceed the amount paid or payable to the provider. Read the Bill »

Outcome

Bill Has Failed

History

DateAction
01/12/2009Prefiled and ordered printed; offered 01/14/09 090015204
01/12/2009Referred to Committee on Commerce and Labor
01/16/2009Impact statement from DPB (SB964)
01/26/2009Passed by indefinitely in Commerce and Labor (11-Y 0-N) (see vote tally)