Health Care Facilities – Notice to Consumers – Out–of–Network Status (Health Care Provider Out–of–Network Information Act)
Impact
The bill is poised to significantly alter how health care facilities interact with consumers by imposing stringent requirements on communication. Specifically, these facilities are prohibited from charging beyond the in-network cost share unless informed consent is obtained from the consumer after they receive the required notices. Violations of this act will be classified as unfair trade practices under the Maryland Consumer Protection Act, thus providing consumers with a new layer of legal protection against deceptive billing practices.
Summary
Senate Bill 1104, known as the Health Care Provider Out-of-Network Information Act, mandates that out-of-network health care facilities provide consumers with vital information before delivering services. This information must include a notice about their out-of-network status, a written estimate of the expected costs, and details on obtaining consumer assistance. The aim is to ensure that consumers are fully aware of the potential out-of-pocket expenditures when they seek services at a facility that does not participate in their health plan network.
Contention
One major point of contention surrounding SB 1104 revolves around the balance of responsibility between healthcare providers and consumers. Supporters believe that these measures can substantially mitigate unexpected healthcare costs and improve transparency in medical billing. Conversely, opponents may argue that the regulations could lead to increased operational burdens for out-of-network providers and might discourage them from offering services to consumers, potentially limiting care options.