Health insurance; payment to out-of-network providers, emergency services. (SB1228)

Introduced By

Sen. Amanda Chase (R-Midlothian)

Description

Health insurance; payment to out-of-network providers; 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, less applicable cost-sharing requirements, the greatest of (i) the amount negotiated with out-of-network providers for the emergency service or, if more than one amount is negotiated, the median of these amounts; (ii) the amount for the emergency service calculated using the same method the health carrier generally uses to determine payments for out-of-network services, such as the usual, customary, and reasonable amount; or (iii) the amount that would be paid under Medicare for the emergency service. 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. Amends § 38.2-3407.13:2, § 38.2-3438, § 38.2-3445, of the Code of Virginia. Read the Bill »

Status

01/04/2019: Awaiting a Vote in the Commerce and Labor Committee

History

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