Bill > S902

This bill aims to lower healthcare prices for patients by establishing a cap on the rates that healthcare providers, hospitals, and provider organizations can charge for services. Specifically, the bill limits charges to no more than 200 percent of the amount paid by Medicare for a given service. The legislation defines key terms such as "health care provider" (which includes any entity that delivers or bills for healthcare services), "hospital" (including licensed medical facilities and psychiatric facilities), and "provider organization" (any group representing healthcare providers in contract negotiations). Under the bill, these entities are prohibited from billing patients at rates exceeding the 200 percent Medicare threshold and are not allowed to balance bill patients beyond the payor's payment, except for standard co-payments, co-insurance, and deductibles. Additionally, providers cannot attempt to recoup lost revenue by increasing charges to other health benefit plans or payers. The bill grants the state department authority to create regulations monitoring compliance, with the attorney general also empowered to review and ensure adherence to these new pricing restrictions. By implementing these limits, the legislation seeks to make healthcare more affordable and transparent for patients by tying maximum charges to established Medicare payment rates.

Health and Social Services

https://malegislature.gov/Bills/194/S902