SB 505 – Medical Billing Transparency

SB 505 – Medical Billing Transparency

Primary Senate Sponsors: Sen. Joyce Krawiec (R-Davie, Forsyth); Sen. Jim Burgin (R-Harnett, Johnston, Lee); Sen. Jim Perry (R-Lenoir, Wayne)

Summary

This bill:

• Requires all contracts for participation as an in-network health services facility between an insurer offering health benefit plans and a health services facility at which there are out-of-network providers who may be part of the provision of services to an insured to require the facility to provide at least 72 hours’ advanced written notification to an insured that has scheduled an appointment at the facility of any out-of-network provider who will provide health care services to the insured.
• Requires facilities to provide written notice to the insured on the day the appointment is scheduled if there is not at least 72 hours between the scheduling of the appointment and the appointment.
• Requires the facility to provide written notice to the insured as soon as reasonably possible in the case of emergency services.
• Requires the written notice to provide an estimated cost to the insured of the services being rendered by out-of-network providers.
• Allows an insurer to recover related overpayments made to any provider/facility by making demands for refunds from the insured, the provider, or the facility.

Movement

Filed – 4/5/2021