NOTE: As provided in LFC policy, this report is
intended only for use by the standing finance committees of the
legislature. The Legislative Finance Committee does not assume
responsibility for the accuracy of the information in this report when used for
other purposes.
The most recent FIR
version (in HTML & Adobe PDF formats) is available on the Legislative
Website. The Adobe PDF version includes
all attachments, whereas the HTML version does not. Previously issued FIRs and attachments may be
obtained from the LFC in
SPONSOR: |
Hurt |
DATE TYPED: |
|
HB |
|
||
SHORT TITLE: |
Mandatory Assignment of Health Claims |
SB |
150 |
||||
|
ANALYST: |
|
|||||
APPROPRIATION
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
||
FY03 |
FY04 |
FY03 |
FY04 |
|
|
|
NFI |
|
|
|
|
Responses
Received From
General Services Administration (GSD)
Agency on Aging (AOA)
Public School Insurance Authority (PSIA)
Retiree Health Care Authority (RHCA)
Public Regulation Commission (PRC)
Department of Health (DOH)
Health Policy Commission (HPC)
SUMMARY
Synopsis
of Bill
Senate Bill 150 enacts
a new section of the Insurance Code. It
requires a health care provider to bill a patient’s health care plan directly,
The provider may not collect any payment from the patient except a co-payment,
coinsurance, deductible or other amount for which the patient is liable
under the health care plan.
Significant
Issues
Patients
should have the right to designate the payee associated with their health plan
benefits. “Assignment of Benefits” is
widely accepted in the health insurance industry. GSD notes that all vendors associated with
health plans serving State of
Patients who have insurance are sometimes
required to pay up-front for their health care and then wait to be reimbursed
by their health care plan. For some people, this can cause financial hardship,
and might act as a deterrent to seeking necessary medical assistance. Delays in care can often lead to more
serious, and more costly, health conditions.
ADMINISTRATIVE IMPLICATIONS
The PRC is responsible
for enforcing the provisions of the Insurance Code. SB 150 will add only a very
small increase to the workload.
POSSIBLE QUESTIONS
In the event that a health plan does not pay for
services rendered by a non-participating provider, will the provisions in SB150 require that
those services go uncompensated?
DW/njw