Bill > H3302

This bill seeks to protect South Carolina patients from unexpected medical bills, known as "surprise bills," by establishing clear regulations for healthcare insurers and providers. The bill defines a "surprise bill" as a charge for healthcare services received from an out-of-network provider at an in-network facility, during a procedure performed by an in-network provider, or in emergency situations where the patient did not knowingly choose an out-of-network provider. The legislation prohibits insurers from imposing higher out-of-pocket expenses for emergency services from out-of-network providers compared to in-network services and requires insurers to reimburse out-of-network providers at either the in-network rate, the usual and customary rate, or the Medicare reimbursement rate, whichever is greatest. Patients will only be responsible for the same out-of-pocket costs they would pay for in-network services, and healthcare providers are prohibited from billing patients beyond these amounts. The bill also classifies surprise billing as an unfair trade practice and mandates that the Department of Insurance report on the effectiveness of dispute resolution practices between providers and insurers within one year of the law's implementation. The legislation aims to protect patients from unexpectedly high medical bills, particularly in emergency or uncontrolled medical situations.

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https://www.scstatehouse.gov/billsearch.php?billnumbers=3302&session=126&summary=B