Plain English Breakdown
Checked against official source text during the last sync.
Health Care Provider Notification Requirements
This bill requires health care providers to inform patients if they are out-of-network before providing nonemergency medical services.
What This Bill Does
- Defines key terms like 'health benefit plan', 'health care provider', and 'nonemergency care'.
- Requires health care providers to determine whether a patient is covered by a health benefit plan.
- Requires health care providers to determine their network status with any health benefit plans covering the patient.
- If a health care provider is out-of-network, they must notify the patient or the person giving consent for nonemergency care.
Who It Names or Affects
- Health care providers who offer nonemergency medical services.
- Patients receiving nonemergency medical services and their representatives.
Terms To Know
- Out-of-network
- A health care provider that is not part of a patient's insurance network, which can result in higher costs for the patient.
- Health benefit plan
- An insurance policy or program that covers medical expenses and services.
Limits and Unknowns
- The bill does not specify penalties for health care providers who do not comply with these requirements.
- It is unclear how this law will be enforced or monitored by state agencies.