House Bill 799, sponsored by Representative Sharon Cooper (R – Marietta), Chair of the House Health & Human Services Committee, applies solely to emergency care and medically necessary follow-up care. The legislation disallows managed care plans from denying payment for emergency services and disallows out-of-network (OON) hospitals from billing patients for medically necessary care following an emergency situation except for their standard co-pays, co-insurance, and deductibles. For a patient receiving emergency care at an OON hospital and who is covered by a plan that requires prior authorization for post-stabilization care, the legislation outlines how the OON hospital and insurer must coordinate the patient’s transfer to an in-network facility. Under this bill, if a patient (or their representative) does not consent to be transferred to an in-network hospital, the OON hospital must provide verbal notice to the patient that they may be financially responsible for any further post-stabilization care provided. This bill protects insured consumers from unexpected OON hospital bills in emergency situations.
Update: Unfortunately, HB 799 did not advance during the 2018 Legislative Session.