HB 1546

Abstract

Health benefit plans; bills for emergency services; surprise bills; dispute resolution. Requires the Commissioner of the Bureau of Insurance to certify independent dispute resolution entities to resolve disputes arising from surprise bills for non-emergency health care services and for emergency service provided by non-participating providers. The measure implements "baseball-style" arbitration to resolve disputes between health carriers and physicians. Under this approach, each party submits a proposed dollar amount to the independent dispute resolution entity, who then chooses one as the appropriate payment amount. The measure provides that when an insured assigns benefits for a surprise bill or a bill for emergency services in writing to a non-participating physician who knows the insured is covered under a health benefit plan, the non-participating physician shall not bill the insured except for any applicable coinsurance, copayment, or deductible that would be owed if the insured utilized a participating physician. This bill was incorporated into HB 1251.