Findings—Intent—2019 c 427; Short title; Definitions; Dispute resolution process—Determination of commercially reasonable payment amount; Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists; Health care provider—Requirement to provide certain information on website or upon consumer request—Requirement to submit network status information to carriers; Carrier—Requirement to update website and provider directory—Requirement to provide enrollee with certain information; Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner; Determining the adequacy of provider networks—Required considerations; Allowed amounts paid to nonparticipating providers; Application of state and federal requirements—Applicability information access—Waivers prohibited

Concerning Gag Clauses in Individual and Group Health Benefit Plans

Health-care facilities – emergency and nonemergency services – required disclosures – balance billing – rules – definitions.

Health-care providers – required disclosures – balance billing – rules – definitions

Insurance – Conformity With Federal Law – The No Surprises Act and Other
Provisions of the Consolidated Appropriations Act, 2021

Purpose and Applicability, Definitions, Out-of-Network Notice and Disclosure Requirements, Health Benefit Plan Issuer and Administrator Responsibility

Concerning the requirements for provider data requests and carrier responses confirming out-of-network payment methodology utilization

Reimbursement for unanticipated out-of-network care

Concerning the requirements for provider data requests and carrier responses confirming out-of-network payment methodology utilization

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.