| Last Action | 01/10/19: to Banking & Insurance (H) |
|---|---|
| Title | AN ACT relating to surprise billing. |
| Bill Documents | Introduced |
| Fiscal Impact Statement | Health Mandate |
| Bill Request Number | 399 |
| Sponsors | J. Sims Jr, C. Stevenson |
| Summary of Original Version | Amend KRS 304.17A-005 to define "balance billing," "cost sharing," "covered person," "usual and customary rate," and other terms; create new sections of Subtitle 17A of KRS Chapter 304 to require the insurance commissioner or a designated nonprofit organization to establish and maintain a database of billed health care services charges collected from insurers; define "unanticipated out-of-network care"; require an insurer to reimburse for unanticipated out-of-network care at the lower of the billed amount or the usual and customary rate less any cost sharing owed by the covered person; prohibit balance billing from a provider who has been reimbursed as required; allow a provider to bill for any applicable cost-sharing requirements owed by the insured; amend KRS 304.17A-096, 304.17A-430, 304.17A-500, 304.17B-001, 304.17B-015, 304.17B-033, 304.17C-010, 304.18-114, 304.38A-010, and 304.39-241 to conform; repeal KRS 304.17A-640; EFFECTIVE January 1, 2020. |
| Index Headings of Original Version |
Effective Dates, Delayed - Health care services, out-of-network care, reimbursement and billing, January 1, 2020 Insurance, Health - Insurers, billed claims, required reporting of Insurance, Health - Unanticipated out-of-network care, balance billing, prohibition against Insurance, Health - Unanticipated out-of-network care, minimum reimbursement for Insurance, Health - Unanticipated out-of-network care, usual and customary rate, definition of Physicians and Practitioners - Out-of-network health care services, balance billing, prohibition against State Agencies - Database of billed health care services charges, commissioner of insurance Health Benefit Mandate - Unanticipated out-of-network care, balance billing, prohibition against |
| 01/09/19 |
|
|---|---|
| 01/10/19 |
|
Last updated: 11/9/2023 3:07 PM (EST)