| Last Action | to Banking & Insurance (S) | 
|---|---|
| Title | AN ACT relating to surprise billing. | 
| Bill Documents | Introduced | 
| Impact Statements | Health Mandate | 
| Bill Request Number | 1929 | 
| Sponsor | R. Girdler | 
| Summary of Original Version | Amend KRS 304.17A-500 to define "facility" and "in-network facility"; create new sections 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 their in-network cost sharing; amend KRS 304.17A-565 to make technical corrections and to provide that the provisions of 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 and 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 | Local Mandate - Nonparticipating health care providers, billing restrictions for Effective Dates, Delayed - Nonparticipating health care providers, billing restrictions for, January 1, 2018 Health and Medical Services - Nonparticipating health care providers, billing restrictions for Hospitals and Nursing Homes - Contracts with insurers, requirements Insurance, Health - Contracts with health facilities, requirements 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 | 
| 03/01/18 | 
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| 03/05/18 | 
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Last updated: 1/16/2019 3:00 PM (EST)