| Last Action | 01/07/20: to Banking & Insurance (H) |
|---|---|
| Title | AN ACT relating to surprise billing. |
| Bill Documents | Introduced |
| Fiscal Impact Statement | Health Mandate |
| Bill Request Number | 475 |
| Sponsors | C. Stevenson, J. Sims Jr, T. Bojanowski, C. Booker, G. Brown Jr, T. Burch, M. Cantrell, J. Donohue, K. Flood, A. Gentry, J. Glenn, D. Graham, J. Graviss, C. Harris, A. Hatton, K. Hinkle, C. Howard, J. Jenkins, N. Kulkarni, M. Marzian, R. Meeks, R. Meyer, C. Miller, P. Minter, R. Palumbo, R. Rand, J. Raymond, D. Schamore, M. Sorolis, W. Stone, A. Tackett Laferty, S. Westrom, B. Wheatley, R. Wiederstein, L. Willner |
| Summary of Original Version | Amend KRS 304.17A-005 to define "balance billing," "cost sharing," 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," "covered person" and "usual and customary rate"; 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 covered person; amend KRS18A.225, 304.17A-0954, 304.17A-096, 304.17A-500, 304.17A-580, 304.17A-649, 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, 2021. |
| Index Headings of Original Version |
Health Benefit Mandate - Unanticipated out-of-network care, minimum reimbursement for Effective Dates, Delayed - Unanticipated out-of-network care, reimbursement and billing, January 1, 2021 Insurance, Health - Unanticipated out-of-network care, minimum reimbursement for Physicians and Practitioners - Unanticipated out-of-network care, balancing billing, prohibition against State Agencies - Department of Insurance, commissioner, database of billed health care service charges State Employees - State employee health plan, unanticipated out-of-network care, minimum reimbursement for Administrative Regulations and Proceedings - Department of Insurance, commissioner, database of billed health care services |
| 12/13/19 |
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|---|---|
| 01/07/20 |
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Last updated: 10/27/2020 12:10 PM (EDT)
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