Five things to know:
1. Mr. Frierson will present the legislation to the Assembly Health and Human Services Committee on April 10.
2. Under the legislation, AB469, patients who receive care in an out-of-network hospital for an emergency or because they reasonably thought they were in an emergency would only have to pay copays, coinsurance and deductibles they would have had if the hospital had been in their insurance company’s network, the Independent reports.
3. The bill also includes a process that determines reimbursement from insurers to out-of-network providers for emergency services.
4. The legislation has a two-tiered payment system for insurers and providers who contracted in the last 24 months. For insurers and providers who did not recently contract, both sides would make offers, and the issue goes to arbitration if the sides are not able to reach a resolution.
5. Mr. Frierson told the Independent neither insurers or providers are abundantly pleased with the legislation, which means lawmakers “probably did a good thing” as far as a fair and balanced approach.
Access the full Independent report here.
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