Bill > S2364

This bill aims to protect access to invaluable, economical, and necessary medical treatments. The key provisions include: 1. Establishing noncontracted commercial rates for emergency and nonemergency services provided by out-of-network healthcare providers, to be set by a state commission and applied for a 5-year term. These rates are intended to balance cost, provider participation, and understandability. 2. Prohibiting the state's Group Insurance Commission from imposing separate copayments or reimbursing facility fees for certain outpatient hospital services, and restricting hospitals and health systems from charging facility fees beyond certain limitations. 3. Requiring healthcare providers to disclose their network status, estimated costs, and patient options when scheduling services, and obtain prior written consent from patients before providing out-of-network care (except for emergency services). 4. Directing the state to establish a task force to develop recommendations for ensuring the accuracy of carrier provider directories. 5. Capping the noncontracted commercial rates at the 80th percentile of allowed charges for a given service in the same geographic area, as reported by a non-profit benchmarking organization. 6. Requiring the state's Center for Health Information and Analysis to report on the implementation of the facility fee protections.

Budget and Finance, Health and Social Services

Joint Committee on Financial Services (J)

https://malegislature.gov/Bills/191/S2364