The bill mandates that health care entities provide patients with a good faith estimate of costs associated with health care services prior to the services being rendered. It requires health care entities to inform patients about the availability of price information for frequently provided services and to post notices regarding patients' rights to request such information. Additionally, health insurance carriers must provide insured patients with an advanced explanation of benefits within three business days of receiving a good faith estimate. The legislation establishes a new chapter, Chapter 358-U, which outlines definitions related to health care pricing and the obligations of health care entities to disclose information to both uninsured and insured patients. Notably, it prohibits collection actions against uninsured or self-pay patients for noncompliance with the good faith estimate requirements.
Key provisions include the insertion of sections that require hospitals to comply with federal price transparency regulations and empower the Department of Health and Human Services to establish rules for standardized data disclosure, along with penalties for noncompliance. The bill also mandates that, starting January 1, 2026, health carriers develop a website and toll-free number to provide enrollees with estimated costs for health care services and quality data for network providers. While the bill does not allocate funding and its fiscal impact remains indeterminable, it aims to enhance transparency in healthcare pricing and billing practices, ultimately improving patient access to pricing information and holding healthcare providers accountable.