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Out-of-network Health Care Services

Concerning out-of-network health care services provided to covered persons.
2019 Regular Session
Bill Summary

The bill:

  • Requires health insurance carriers, health care providers, and health care facilities to provide patients covered by health benefit plans with information concerning the provision of services by out-of-network providers and in-network and out-of-network facilities;
  • Outlines the disclosure requirements and the claims and payment process for the provision of out-of-network services;
  • Requires the commissioner of insurance, the state board of health, and the director of the division of professions and occupations in the department of regulatory agencies to promulgate rules that specify the requirements for disclosures to consumers, including the timing, the format, and the contents and language in the disclosures;
  • Establishes the reimbursement amount for out-of-network providers that provide health care services to covered persons at an in-network facility and for out-of-network providers or facilities that provide emergency services to covered persons; and
  • Creates a penalty for failure to comply with the payment requirements for out-of-network health care services.
    (Note: This summary applies to this bill as introduced.)


Under Consideration


Bill Text


Sponsor Type Legislators
Prime Sponsor

Rep. M. Catlin, Rep. D. Esgar
Sen. B. Gardner, Sen. B. Pettersen



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