The legislation, signed into law May 15, limits how much an out-of-network provider can charge a patient for certain medically necessary emergency services. That amount is limited to a patient’s insurance copay, coinsurance or deductible, according to the Current.
The bill also includes a process that determines reimbursement from insurers to out-of-network providers for emergency services.
Additionally, it includes a process for out-of-network providers to transfer patients to a hospital that is in the patient’s insurance network, or to an independent center for emergency care, within 24 hours, according to the report.
Under the legislation, insurers are required to pay a portion of the contracted rate if the out-of-network provider was previously contracted with the insurer.
Read more about the legislation here.
More articles on healthcare finance:
OhioHealth’s Margaret Schuler on automation in revenue cycle and meeting patients’ expectations
Federal push for greater price transparency would likely affect insurers less, Fitch analyst says
RCM tip of the day: Collaborate with payers
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
