Bill > S1319

This bill, titled the Emergency Care Affordability Act, aims to protect patients with health benefit plans from unexpectedly high medical bills for emergency services received at out-of-network freestanding emergency rooms or from out-of-network providers. A "freestanding emergency room" is defined as a facility not part of a hospital's main campus that primarily provides unscheduled emergency services 24 hours a day, and often operates on an out-of-network basis. The bill mandates that these out-of-network facilities must accept the "allowed amount" – the payment a health benefit plan would typically make to an in-network provider for the same service – as full payment for emergency services. Patients will only be responsible for their usual in-network cost-sharing amounts, and providers cannot bill patients for amounts exceeding this allowed amount. The bill also clarifies that any agreements patients sign waiving these protections are void. For self-funded health plans, participation in these provisions is optional and requires annual notification to the Department of Insurance. The bill includes enforcement mechanisms, allowing patients to recover attorney's fees and costs if a provider violates these provisions, and makes any improper billing void and unenforceable.

Business and Industry, Justice

State Affairs Committee (Senate)

https://legislature.idaho.gov/sessioninfo/2026/legislation/S1319/