Balance billing; emergency services. (HB1714)

Introduced By

Del. Lee Ware (R-Powhatan) with support from co-patron Del. Kaye Kory (D-Falls Church)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Balance billing; emergency services. Directs health carriers that provide individual or group health insurance that provide any benefits with respect to services rendered in an emergency department of a hospital to pay directly to an out-of-network health care provider the fair market value for the emergency services, less applicable cost-sharing requirements. The bill provides that direct payment from the health carrier to the out-of-network health care provider precludes the out-of-network health care provider from billing or seeking payment from the covered person for any other amount other than the applicable cost-sharing requirements. The measure defines fair market value as that price that is determined by considering the amounts billed to and accepted from health carriers or managed care plans by similar providers for comparable out-of-network emergency services in the community where the services were rendered, with the exclusion of amounts accepted by providers for patients covered by Medicare or Medicaid. The bill removes from the determination of whether a medical condition is an emergency medical condition the final diagnosis rendered to the covered person. Read the Bill »


Bill Has Failed


12/14/2018Prefiled and ordered printed; offered 01/09/19 19102436D
12/14/2018Referred to Committee on Commerce and Labor
01/10/2019Assigned C & L sub: Subcommittee #1
01/17/2019Impact statement from DPB (HB1714)
01/17/2019House subcommittee amendments and substitutes offered
01/31/2019House committee, floor amendments and substitutes offered
01/31/2019Committee substitute printed 19105052D-H1
01/31/2019Reported from Commerce and Labor with substitute (18-Y 3-N) (see vote tally)
01/31/2019Referred to Committee on Appropriations
02/05/2019Left in Appropriations