Health care services; terms; documentation; prohibiting certain billing; deductible; codification; effective date.
Impact
If enacted, HB 1853 will impact state laws regarding how health benefit plans operate, particularly about out-of-pocket expenses and billing practices. The bill stipulates that healthcare providers must accept the negotiated payments from enrollees as full payment and prohibits any additional billing to the enrollees beyond what they have agreed to pay. Additionally, certain costs associated with these services will count towards the insurance deductible and annual out-of-pocket expenses. This provision could lead to significant changes in the interactions between patients and healthcare providers, as well as with insurance companies.
Summary
House Bill 1853 aims to address the complexities associated with healthcare expenses and insurance billing in Oklahoma by allowing enrollees to negotiate lower prices for medical services and have those costs counted towards their deductibles and out-of-pocket maximums. This bill enables individuals who receive medically necessary services and pay out of pocket to submit documentation to their health carriers, ensuring their negotiated payments are recognized by their insurance providers. The bill is seen as an advancement in enabling consumers to have more control over their healthcare costs, especially as healthcare expenses continue to rise.
Sentiment
General sentiment regarding HB 1853 appears favorable among supporters who advocate for increased consumer rights and cost transparency in the healthcare system. Proponents believe the bill empowers patients by legitimizing their ability to negotiate healthcare costs and ensuring those payments are not disregarded by insurance carriers. However, there may be concerns among some healthcare providers and insurers regarding the enforceability of these requirements and how they could affect revenue and operational practices.
Contention
Notable points of contention around HB 1853 involve the implications for healthcare providers, who may be wary about the financial impact this bill could have on their billing practices. Critics may argue that requiring providers to accept negotiated prices as full payment could undermine the value of their services or create additional administrative burdens. Some stakeholders worry that while the bill aims to help consumers save money, it may inadvertently lead to increased costs in other areas or decrease the incentive for providers to deliver quality care.
Health insurance; requiring certain high deductible health plans to allow an insured to set aside funds for medical expenses subject to certain limitations. Effective date.
Health insurance; requiring certain high deductible health plans to allow an insured to set aside funds for medical expenses subject to certain limitations. Effective date.
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