Bill > HB1276

This bill expands a requirement for healthcare providers to give patients a good faith estimate of their out-of-pocket costs for nonemergency health care services, moving beyond the current law which only mandates this for hospitals. A "good faith estimate" is a written prediction of the patient's financial responsibility, including any related fees, for scheduled nonemergency medical care, which is defined as any service for health conditions except emergencies. This estimate must detail the service, the provider's standard charges, and any known contracted rates with the patient's health carrier, while also stating that the final billed amount may differ and explaining how an unmet deductible might affect the patient's cost. The bill also clarifies that providers are not liable if the patient or their health carrier provides inaccurate information or if the carrier later processes a claim differently, and it does not require providers to definitively determine if they are in-network for a specific health plan.

Business and Industry

https://lis.virginia.gov/bill-details/20261/HB1276