The bill establishes limitations on hospital-related charges for inpatient and outpatient care, capping these charges at 250% of the reimbursement rate set by the Medicare program. It allows individuals who believe they have been overcharged to file complaints with the department, which will investigate and determine if a violation has occurred. If a violation is found, the hospital must reimburse the complainant for the excess amount charged. Additionally, if a health insurance issuer files a complaint and is reimbursed for an overcharge, they are required to credit or refund the insured for the amount paid, minus any applicable cost-sharing.
The bill also includes provisions for hospitals to file their chargemaster rates with the department annually, and if changes are made to the chargemaster, hospitals must file the new rates at least 60 days before implementation. It clarifies that the term "hospital-related charge" does not include charges from individual providers who are not employees of the hospital but bill through it. The bill is set to take effect on January 1, 2024.