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AB 1611: Emergency Hospital Services: Costs (2019 - 2020)

Summary: 

Would require a health care service plan contract or insurance policy issued, amended, or
renewed on or after January 1, 2020, to provide that if an enrollee or insured receives covered
services from a noncontracting hospital, the enrollee or insured is prohibited from paying more than
the same cost sharing that the enrollee or insured would pay for the same covered services received
from a contracting hospital. The bill would require a health care service plan or insurer to pay a
noncontracting hospital for emergency services rendered to an enrollee or insured pursuant to a
specified formula, would require a noncontracting hospital to bill, collect, and make refunds in a
specified manner, and would provide a dispute resolution procedure if any party is dissatisfied with
payment.

Author: 
Chiu
Category: 
Quality
CPEHN Position: 
Support
Status: 
2-YEAR Initiative