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Prepared by Cheryl Horne.
Abramson HB No. 601
(KEYWORD, SUMMARY, AND DIGEST as amended by Senate committee
amendments)
INSURANCE/HEAL TH: Prohibits healthcare service providers from requiring
consent to payment as a condition for verification of insurance coverage.
DIGEST
Abstract: Prohibits healthcare providers from refusing to submit a claim to a health
insurance issuer under certain circumstances.
Proposed law prohibits a healthcare provider which accepts a patient's health insurance
coverage to require an enrollee or insured to consent to payment for healthcare services as
a condition for verification of health insurance coverage for such healthcare services.
Proposed law provides that it shall not preclude a healthcare provider from requiring the
enrollee or the insured to consent to payment or to request payment for those services before
services are delivered, to consent to payment or payment for those services delivered, or to
require payment in the event a claim is subsequently denied by the health insurance issuer.
Proposed law defines terms "healthcare services", "health insurance coverage", and "health
insurance issuer".
Proposed law provides that any provision in an agreement between a provider of healthcare
services and a health insurance issuer that conflicts with proposed law shall be deemed null
and void.
(Adds R.S. 22:1827)
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Insurance to the original
bill.
1. Deletes provision prohibiting a provider of healthcare services from requiring an
insured, as a condition for furnishing such services, to consent to full payment for
such services in the event that the insured's health insurance issuer denies a claim
for such services.
2. Adds provision making any provision in an agreement between a provider of
healthcare services and a health insurance issuer that conflicts with proposed law
null and void.
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Insurance to the engrossed
bill
1. Deletes the provision prohibiting a provider of healthcare services from requiring
an insured, as a condition for submission of a claim, to consent to full payment
for such services in the event that the insured's health insurance issuer denies a
claim for such services.
2. Deletes the provision that proposed law shall not preclude a provider of
healthcare services from requiring an insured to pay for healthcare services
directly to the provider if the claim is denied after submission to the health
insurance issuer but before the services are provided if still requested by the
insured. Page 2 of 2
Prepared by Cheryl Horne.
3. Adds that no healthcare provider which accepts a patient's health insurance
coverage shall require an enrollee or insured to consent to payment for healthcare
services as a condition for verification of health insurance coverage for such
healthcare services.
4. Adds that proposed law shall not preclude a healthcare provider from requiring
the enrollee or the insured to consent to payment or to request payment for those
services before services are delivered, to consent to payment or payment for those
services delivered, or to require payment in the event a claim is subsequently
denied by the health insurance issuer.