SPONSOR: Hruza
The bill prohibits health carriers from imposing any penalty or fee on in-network health care providers based on the provision of a health care service by an out-of-network health care provider.
This bill enacts provisions governing the determination of health insurance reimbursement amounts for anesthesia services, as described in the bill.
The bill also prohibits health carriers from imposing maximum durations for covered anesthesia.
Under the bill, no health carrier will restrict or exclude all anesthesia time, as defined in the bill, from reimbursement for a health care service for which anesthesia is covered.
Additionally, this bill prohibits contracts from authorizing health carriers to modify or add to a contract, unless certain conditions are met, as specified in the bill. No manual, policy, protocol, procedure, program, or other document is considered binding upon the provider or enrollee unless it is referred to in the contract, is in effect at the time the contract is signed, and is made readily available to each party in an electronic format at or before the time the contract is signed and for the duration for which claims can be submitted for reimbursement under the contract.
Statutes affected: