SB 236/HM (BR 1929) - R. Girdler

     AN ACT relating to surprise billing.
     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.