Bill > H4619

This bill aims to protect health care consumers from surprise billing by establishing several key provisions. It defines and regulates facility fees, which are additional charges hospitals can levy for operational expenses beyond professional medical service fees. The bill restricts when these facility fees can be charged, requiring healthcare providers to give patients clear written notice before billing them and mandating that facilities prominently display signage about potential higher costs. Healthcare providers must notify patients if a facility changes status and becomes hospital-owned, potentially increasing billing complexity. The legislation also addresses out-of-network services, stipulating that patients can only be charged in-network cost-sharing amounts for unforeseen out-of-network services, such as emergency care or services provided by specialists at in-network facilities. Insurance carriers must reimburse out-of-network providers at the median contracted rate for the geographic region, and providers cannot bill patients beyond the standard in-network cost-sharing amounts. The bill empowers the attorney general to investigate violations, allows licensing authorities to impose penalties, and creates mechanisms to prevent fraudulent billing practices. Additionally, the legislation requires carriers to reimburse certain off-campus medical services at rates equivalent to Medicare's non-facility rates, potentially reducing overall healthcare costs for consumers.

Health and Social Services

Joint Committee on Financial Services (J)

https://malegislature.gov/Bills/194/H4619