Relating to billing and reimbursement for certain medical equipment, devices, and supplies provided to Medicare enrollees; creating a criminal offense.
Impact
This legislation is expected to impact the operations of suppliers who do not participate in Medicare. By enforcing limitations on how much nonparticipating suppliers can charge, the bill aims to protect Medicare enrollees from excessive costs that could arise from nonparticipating billing practices. Additionally, the bill reinforces the framework within which Medicare reimbursement occurs, signaling a shift towards greater accountability among suppliers.
Summary
House Bill 3150 addresses billing and reimbursement practices for certain medical equipment, devices, and supplies provided to Medicare enrollees. The bill establishes regulations specifically governing nonparticipating suppliers, detailing the conditions under which they can charge enrollees for durable medical equipment and devices. It stipulates that these suppliers may not charge more than 115% of the Medicare-approved amount without the enrollee's prior written consent.
Contention
There may be points of contention surrounding the implications of the criminal offense clause within the bill. Suppliers that violate the established billing practices face penalties categorized as misdemeanors, punishable by fines ranging from $500 to $1,000. Critics could argue that this approach might disproportionately affect smaller suppliers who may struggle with compliance, potentially limiting access to necessary medical equipment for enrollees.
Enforcement
The enforcement mechanisms outlined in the bill stipulate that violations will fall under the jurisdiction of deceptive trade practices law. This enforcement paradigm is intended to bolster consumer protections by holding nonparticipating suppliers accountable for unethical billing practices. Overall, HB3150 seeks to enhance regulatory oversight concerning billing for durable medical equipment, ultimately aiming to improve the financial experience of Medicare enrollees.
Identical
Relating to billing and reimbursement for certain medical equipment, devices, and supplies provided to Medicare enrollees; creating a criminal offense.
Relating to the establishment of the state health benefit plan reimbursement review board and the reimbursement for health care services or supplies provided under certain state-funded health benefit plans.
Relating to the administration, provision, and Medicaid reimbursement of mental health or behavioral health services provided to certain public school students.