Health benefit plans; bills for emergency services, surprise bills, dispute resolution. (HB1546)

Introduced By

Del. Dawn Adams (D-Richmond) with support from co-patrons Del. Sam Rasoul (D-Roanoke), Del. Lee Ware (R-Powhatan), and Sen. Lamont Bagby (D-Richmond)

Description

Health benefit plans; bills for emergency services; surprise bills; dispute resolution. Requires the Commissioner of the Bureau of Insurance to certify independent dispute resolution entities to resolve disputes arising from surprise bills for non-emergency health care services and for emergency service provided by non-participating providers. The measure implements "baseball-style" arbitration to resolve disputes between health carriers and physicians. Under this approach, each party submits a proposed dollar amount to the independent dispute resolution entity, who then chooses one as the appropriate payment amount. The measure provides that when an insured assigns benefits for a surprise bill or a bill for emergency services in writing to a non-participating physician who knows the insured is covered under a health benefit plan, the non-participating physician shall not bill the insured except for any applicable coinsurance, copayment, or deductible that would be owed if the insured utilized a participating physician. This bill was incorporated into HB 1251. Read the Bill »

Status

02/04/2020: Incorporated into Another Bill

History