Signed by Governor Eric Holcomb

Vote Smart's Synopsis:

Vote to adopt a conference report and pass a bill that requires healthcare providers provide "good faith" estimates of medical costs to patients prior to receiving medical services.

Highlights:

• Prohibits offices or managed care organizations contracting with the office from preventing a provider from participating in a network of another insurer, manage care, or health maintenance organization (Sec 1). 

• Expands the list of categories of weighted average negotiated charge per service per provider type to include Medicaid (Sec 4). 

• Requires an in-network practitioner who provides covered services to a covered individual to not charge more than allowed according to the rate of compensation established by the individual’s network plan (Sec 23). 

• Prohibits an out of network practitioner providing services at an in-network facility to a covered individual from being reimbursed above the rate established by the covered individual’s network plan unless all of the following conditions are met (Sec 23):

•  5 days before the services are scheduled the patient is informed of the intent to overcharge in writing;

• The individual receiving services receives a statement of explanation as to why the good faith estimate charge is lower than the proposed charge; and

• The covered individual signs the statement agreeing to pay the new charge greater than the allowed amount according to the rate established by the network plan.

• Requires good faith estimates provided by a practitioner to an individual to meet the following requirements (Sec 14): 

• Includes a summary of the services and items the estimate is based on;

• The price charged for the services and items that the practitioner will provide;

• The services of the staff of the provider facility; 

• Any medication, supplies, equipment and other items to be provided to or used by the individual; and

• A total figure of the estimated prices.  

• Requires employers to notify the patients from the past two years of any physician that leaves their employment (Sec 19). 

• Requires employers to provide the last known contact information of the physician that has left their place of employment to patients that request it (Sec 19).

Full Bill Text