Bill > H957

This bill aims to protect consumers from surprise billing for non-contracted and non-emergency healthcare services. It does this in several ways: 1. It directs the state's Health Policy Commission to recommend non-contracted commercial rates for emergency and non-emergency services, which would apply to payments by health insurers. These rates would be in effect for 5-year terms. 2. It prohibits the state employee health insurance plan (Group Insurance Commission) from imposing separate copayments or reimbursing hospitals/health systems for facility fees for certain evaluation and management services. It also prohibits hospitals/health systems from charging patients facility fees above the insurer's agreed rate. 3. It bans hospitals, health systems, and hospital-based facilities from charging facility fees for services using certain medical billing codes, and prohibits them from offsetting this lost revenue through increased rates or fees on insurers or patients. The bill is intended to address the issue of patients receiving unexpected, high charges from out-of-network providers, even when receiving care at in-network facilities. It seeks to set standard rates and limit certain facility fee practices to protect consumers.

Business and Industry

https://malegislature.gov/Bills/191/H957