Requires health insurance issuers to directly pay noncontracted health care providers of emergency services for their charges as determined pursuant to the plan or policy of enrollee and insurer. (8/15/10)
Impact
The enactment of SB683 will have a significant impact on how health insurance claims are processed in the context of emergency medical services. By mandating direct payments to noncontracted providers, the bill seeks to alleviate some of the burdens on these providers, who often face challenges when billing insurance companies for services delivered in emergencies. This can improve the financial stability of emergency care providers and encourage more to offer their services without being part of an insurer’s network.
Summary
Senate Bill 683 requires health insurance issuers to directly pay noncontracted health care providers for emergency services rendered, with payment amounts determined by the terms of the policy or plan of the insured and the insurer. This means that when a health care provider that is not part of an insurance network submits a claim for emergency services, the insurance issuer must process and pay that claim directly to the provider. The intention behind the bill is to ensure that emergency service providers receive compensation for their services, even if they are not under contract with the patient's health insurance plan.
Sentiment
General sentiment around SB683 appears to be supportive among healthcare providers who are impacted by non-payment or delays in payment from insurance companies. Providers argue that it is essential they receive timely compensation for emergency services rendered. However, there may be concerns from insurance companies about the potential increase in costs associated with direct payments to noncontracted providers, which could lead to higher premiums for consumers. Thus, while the bill is viewed positively by many in the healthcare sector, it may raise issues regarding its financial implications for insurance models.
Contention
Notable points of contention surrounding SB683 could involve the potential financial burden it places on insurance providers, which may argue that requiring direct payments to noncontracted providers could complicate claims processing and lead to higher operational costs. Additionally, while the bill addresses payment for emergency services, there are concerns about how insurers will manage the increased claims and whether this could impact the premiums for insured individuals. Some stakeholders may also argue about the definition of emergency services and the extent to which noncontracted providers should be compensated under various policy terms.
Provides relative to balance billing by and reimbursement of noncontracted facility-based physicians for covered health care services rendered in an in-network health care facility. (8/1/14)
Provides relative to balance billing by and reimbursement of noncontracted facility-based physicians for covered health care services rendered in an in-network health care facility. (8/1/16)
Provides relative to balance billing by noncontracted facility-based physicians for covered health care services rendered in an in-network health care facility
Provides relative to balance billing by and reimbursement of noncontracted facility-based physicians for covered health care services rendered in an in-network health care facility