An Act to protect health care consumers from surprise billing
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Overview
This bill aims to protect Massachusetts residents from unexpected, high medical bills that often occur when they receive care from out-of-network providers. It seeks to ensure that patients are only responsible for the cost of care that aligns with their insurance coverage, particularly in emergency situations or when receiving care at in-network facilities but treated by an out-of-network doctor. The legislation intends to clarify billing practices and provide greater transparency for consumers regarding their healthcare costs.
Key provisions
- Requires out-of-network providers to provide a clear estimate of costs before providing care.
- Establishes a process for resolving billing disputes between patients and providers.
- Protects patients from being balance billed for amounts exceeding their insurance coverage.
- Addresses surprise billing in emergency situations.
- Specifies how costs should be shared between in-network facilities and out-of-network providers.
- Clarifies the definition of ‘surprise billing’ within the context of Massachusetts law.
- Requires hospitals to notify patients of the out-of-network status of providers.
- Provides a mechanism for patients to appeal unexpected bills.
Who is affected
- Healthcare consumers in Massachusetts
- Hospitals and healthcare facilities
- Out-of-network healthcare providers
- Insurance companies
- Patients receiving emergency care
Bill text
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Sponsors
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2 on record
Primary sponsor
Cosponsor
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