Search state statutes and regulations in all 50 states and the District of Columbia to find out what rights you have in your state and what other states are doing to empower physicians and patients in the face of health insurer market power.
Definitions; Applicability of Chapter; Balance Billing Prohibition Notice; Out-of-Network Claim Dispute Resolution; Emergency Care Payments; Out-of-Network Facility-Based Provider Payments
Unfair Claims Settlement Practices
“Clean Claim” Defined; Notice of Deficiencies in Claims; Payment or Denial of Claims, Interest; Limitations on an Insurer’s Ability to Alter CPT Code or Pay for a CPT Code of Lesser Monetary Value; Civil Penalties; Claim Payment Errors; Claim Overpayment Adjustment
“Clean Claim” Defined; “CPT Code” Defined; “Insurer” Defined; Notice of Deficiencies in Claims; Payment or Denial of Claims, Interest; Limitations on an insurer’s ability to alter CPT code or pay for a CPT code of lesser monetary value; Civil Penalties; Claim Payment Errors; Claim Overpayment Adjustment
Health Insurance – Two–Sided Incentive Arrangements
Basis and scope; Applicability; Definitions; Preventing surprise medical bills for emergency services; Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities; Preventing surprise medical bills for air ambulance services; Methodology for calculating qualifying payment amount; Complaints process for surprise medical bills regarding group health plans and group and individual health insurance coverage; Balance billing in cases of emergency services; Balance billing in cases of non-emergency services performed by nonparticipating providers at certain participating health care facilities; Provider and facility disclosure requirements regarding patient protections against balance billing; Balance billing in cases of air ambulance services; Complaint process for balance billing regarding providers and facilities; Independent dispute resolution process; Independent dispute resolution process for air ambulance services.
Basis and scope; Applicability; Definitions; Preventing surprise medical bills for emergency services; Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities; Methodology for calculating qualifying payment amount; Complaints process for surprise medical bills regarding group health plans and group health insurance coverage; Independent dispute resolution process; Preventing surprise medical bills for air ambulance services; Independent dispute resolution process for air ambulance services
Basis and scope (temporary); Applicability (temporary); Definitions (temporary); Preventing surprise medical bills for emergency services (temporary); Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities (temporary); Methodology for calculating qualifying payment amount; Methodology for calculating qualifying payment amount (temporary); Complaints process for surprise medical bills regarding group health plans (temporary); Independent dispute resolution process, Independent dispute resolution process (temporary); Preventing surprise medical bills for air ambulance services (temporary); Independent dispute resolution process for air ambulance services (temporary)
Preventing surprise medical bills; Ending surprise air ambulance bills
Preventing surprise medical bills; Ending surprise air ambulance bills