HLS 10RS-1515 ORIGINAL
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Regular Session, 2010
HOUSE BILL NO. 822
BY REPRESENTATIVE CORTEZ
INSURANCE/HEALTH-ACCID: Requires health insurance issuers to directly pay
noncontracted health care providers of emergency services for their usual and
customary charges
AN ACT1
To enact R.S. 22:1826, relative to noncontracted providers of emergency services; to require2
health insurance issuers to directly pay such providers their usual and customary3
charges for such services; and to provide for related matters.4
Be it enacted by the Legislature of Louisiana:5
Section 1. R.S. 22:1826 is hereby enacted to read as follows: 6
ยง1826. Payment of claims for emergency services provided by noncontracted health7
care providers8
A. A health care provider that does not contract with a health insurance issuer9
may file a claim with a health insurance issuer for emergency services rendered. The10
health insurance issuer shall directly pay such a claim by a noncontracted provider11
in the amount of the provider's usual and customary charges paid for such12
emergency services, less any amount representing coinsurance, copayments,13
deductibles, noncovered services, or any other amounts identified by the health14
insurance issuer as an amount for which the insured or enrollee is liable. Payment15
of such claim by the health insurance issuer shall in no circumstances be made16
directly to the patient, insured, or enrollee.17
B. For purposes of this Section,"health insurance issuer" means any entity18
that offers health insurance coverage through a policy or certificate of insurance19 HLS 10RS-1515 ORIGINAL
HB NO. 822
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
subject to state law that regulates the business of insurance. The term shall also1
include a health maintenance organization, as defined and licensed pursuant to2
Subpart I of Part I of Chapter 2 of this Title and nonfederal government plans subject3
to the provisions of Subpart B of this Part but shall not include the Office of Group4
Benefits.5
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Cortez HB No. 822
Abstract: Requires health insurance issuers to directly pay noncontracted providers of
emergency services their usual and customary charges for such services.
Proposed law authorizes a health care provider that does not contract with a health insurance
issuer to file a claim with a health insurance issuer for emergency services rendered.
Requires the health insurance issuer to directly pay such a claim by a noncontracted provider
in the amount of the provider's usual and customary charges paid for such emergency
services, less any amount representing coinsurance, copayments, deductibles, noncovered
services, or any other amounts identified by the health insurance issuer as an amount for
which the insured or enrollee is liable. Specifies that payment of such claim by the health
insurance issuer shall in no circumstances be made directly to the patient, insured, or
enrollee.
Proposed law further defines "health insurance issuer" as any entity that offers health
insurance coverage through a policy or certificate of insurance subject to state law that
regulates the business of insurance. Specifies that the term shall also include health
maintenance organizations and nonfederal government plans but shall not include the Office
of Group Benefits.
(Adds R.S. 22:1826)