Senate Bill 235

Last Action to Banking & Insurance (S)
Title AN ACT relating to surprise billing.
Bill Documents Introduced
Impact Statements Health Mandate
Bill Request Number 233
Sponsor T. Buford
Summary of Original Version Amend KRS 304.17A-500 to define "facility" and "in-network facility;" create a new section of KRS 304.17A-500 to 304.17A-590 to require health benefit plans to cover certain nonemergency health care services provided by a nonparticipating health care provider to a covered person at an in-network facility at the in-network rate; prohibit nonparticipating health care providers from attempting to collect payment from a covered person for covered services; provide reimbursement criteria for covered services provided by a nonparticipating provider at an in-network facility; amend KRS 304.17A-254 and KRS 304.17A-527 to conform and to require insurers to require any provider contracts with in-network health facilities requires the provider to accept the in-network rate as payment in full; to prohibit balance billing the covered person beyond his or her in-network cost sharing; amend KRS 304.17A-565 to make technical corrections and to provide that the insurance code shall not preempt or supersede other rights or remedies available to covered persons under law; amend KRS 304.17A-580 to add provisions of KRS 304.17A-641 and to require nonparticipating health care providers accept the in-network reimbursement rate for emergency services provided at an in-network facility as payment in full; amend KRS 18A.225 to remove reference to repealed statute; amend KRS 304.17B-001 to conform; repeal KRS 304.17A-640, 304.17A-641, and 304.17A-649; EFFECTIVE January 1, 2019.
Index Headings of Original Version Health Benefit Mandate - Nonparticipating health care providers, billing restrictions for
Effective Dates, Delayed - Health care, billing restrictions, January 1, 2019
Health and Medical Services - Nonparticipating health care providers, billing restrictions for
Hospitals and Nursing Homes - Contracts with insurers, billing restriction, compliance requiring
Insurance, Health - Contracts with health facilities, billing restrictions, compliance requiring
Insurance, Health - In-network facilities, out-of-network services provided at, reimbursement criteria for
Insurance, Health - In-network facilities, provision of out-of-network services, coverage requirements for
Physicians and Practitioners - Nonparticipating health care providers, billing restrictions for


  • introduced in Senate
  • to Banking & Insurance (S)

Last updated: 1/16/2019 3:00 PM (EST)