VA SB1763 | 2019 | Regular Session

Status

Spectrum: Moderate Partisan Bill (Republican 5-1)
Status: Engrossed on February 5 2019 - 50% progression, died in committee
Action: 2019-02-19 - Left in Appropriations
Pending: House Appropriations Committee
Text: Latest bill text (Engrossed) [HTML]

Summary

Balance billing; emergency and elective services. Directs health carriers that provide individual or group health insurance that provide any benefits with respect to services rendered in an emergency department of a hospital to pay directly to an out-of-network health care provider an amount, less applicable cost-sharing requirements, that is equal to the greatest of (i) the amount negotiated with in-network providers for the emergency service or, if more than one amount is negotiated, the median of these amounts; (ii) the regional average for commercial payments for emergency services as of the date of treatment; (iii) the amount that would be paid under Medicare for an emergency service; and (iv) if out-of-network services are provided (a) by a health care professional, the regional average for commercial payments for such service, or (b) by a facility, the fair market value for such services. The bill removes from the determination of whether a medical condition is an emergency medical condition the final diagnosis rendered to the covered person. The bill requires a facility where a covered person receives scheduled elective services to post the required notice or inform the covered person of the required notice at the time of pre-admission or pre-registration. The bill also requires such a facility to inform the covered person or his legal representative of the names of all provider groups providing health care services at the facility, that consultation with the covered person's managed care plan is recommended to determine if the provider groups providing health care services at the facility are in-network providers, and that the covered person may be financially responsible for health care services performed by a provider that is not an in-network provider, in addition to any cost-sharing requirements. The measure includes an enactment providing that it shall not become effective unless an appropriation that addresses the anticipated effects of this act on the general fund is included in a general appropriation act passed in 2019 by the General Assembly that becomes law.

Tracking Information

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Title

Health insurance; payment to out-of-network providers.

Sponsors


Roll Calls

2019-02-05 - Senate - Senate: Constitutional reading dispensed (39-Y 0-N) (Y: 39 N: 0 NV: 1 Abs: 0) [PASS]
2019-02-05 - Senate - Senate: Passed Senate (40-Y 0-N) (Y: 40 N: 0 NV: 0 Abs: 0) [PASS]
2019-02-04 - Senate - Senate: Constitutional reading dispensed (40-Y 0-N) (Y: 40 N: 0 NV: 0 Abs: 0) [PASS]
2019-02-01 - Senate - Senate: Reported from Finance with amendment (16-Y 0-N) (Y: 16 N: 0 NV: 0 Abs: 0) [PASS]
2019-01-31 - Senate - Senate: Reported from Commerce and Labor with substitute (13-Y 2-N) (Y: 13 N: 2 NV: 0 Abs: 0) [PASS]

History

DateChamberAction
2019-02-19HouseLeft in Appropriations
2019-02-08HouseReferred to Committee on Appropriations
2019-02-08HouseRead first time
2019-02-08HousePlaced on Calendar
2019-02-05SenatePassed Senate (40-Y 0-N)
2019-02-05SenateConstitutional reading dispensed (39-Y 0-N)
2019-02-05SenatePrinted as engrossed 19106123D-ES1
2019-02-05SenateEngrossed by Senate - committee substitute with amendment SB1763ES1
2019-02-05SenateCommittee amendment agreed to
2019-02-05SenateReading of amendment waived
2019-02-05SenateCommittee substitute agreed to 19106123D-S1
2019-02-05SenateReading of substitute waived
2019-02-05SenateRead second time
2019-02-04SenateConstitutional reading dispensed (40-Y 0-N)
2019-02-01SenateReported from Finance with amendment (16-Y 0-N)
2019-01-31SenateRereferred to Finance
2019-01-31SenateIncorporates SB1360 (Wagner)
2019-01-31SenateIncorporates SB1354 (McDougle)
2019-01-31SenateIncorporates SB1228 (Chase)
2019-01-31SenateCommittee substitute printed 19106123D-S1
2019-01-31SenateReported from Commerce and Labor with substitute (13-Y 2-N)
2019-01-18SenateReferred to Committee on Commerce and Labor
2019-01-18SenatePresented and ordered printed 19104632D

Code Citations

ChapterArticleSectionCitation TypeStatute Text
3823438(n/a)See Bill Text
3823445(n/a)See Bill Text

Virginia State Sources


Bill Comments

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