An Act To Establish Patient Protections in Billing for Health Care
Sec. 1. 22 MRSA §1718-B, sub-§2, ¶E is enacted to read:
(1) The average cost of the health care service or procedure in the State;
(2) The health care entity that has the highest cost of the health care service or procedure in the State and the cost of that health care service or procedure;
(3) The health care entity that has the lowest cost of the health care service or procedure in the State and the cost of that health care service or procedure; and
(4) The average cost of the health care service or procedure at the health care facility that will provide the health care service or procedure.
Sec. 2. 22 MRSA §1718-B, sub-§2, ¶F is enacted to read:
Sec. 3. 22 MRSA §1718-E is enacted to read:
§ 1718-E. Prohibition on billing for late billing statements
A health care entity, as defined in section 1718-B, subsection 1, paragraph B, is prohibited from charging a patient for health care services it provided when a billing statement has not been provided to the patient within 6 months of the date health care services were rendered to the patient.
Sec. 4. 22 MRSA §1718-F is enacted to read:
§ 1718-F. Disclosure related to observation status for Medicare patients
A health care entity, as defined in section 1718-B, subsection 1, paragraph B, shall disclose to a patient who is covered by the federal Medicare program and who is on observation status and not an admitted patient at the health care entity the following information:
Sec. 5. 24-A MRSA §4303, sub-§24 is enacted to read:
Sec. 6. 24-A MRSA §4303, sub-§25 is enacted to read:
summary
This bill makes the following changes.
1. The bill requires health care entities, which includes health care practitioners and facilities, to disclose the average cost in the State for the service for which a patient has been scheduled and the entities offering the service at the highest and lowest rates in the State if the patient has been scheduled or referred for one of the 25 highest cost services or procedures.
2. The bill requires health care entities to disclose that a health care facility use fee will be charged and identify that fee separately on any bill provided to a patient.
3. The bill prohibits a health care entity from charging a patient when a billing statement has not been provided within 6 months of the date the patient received the services.
4. The bill requires a health care entity to disclose to a federal Medicare patient who is on observation status that the patient's observation status may increase the patient's out-of-pocket costs associated with a stay at a health care entity and the estimated increase in the patient's out-of-pocket costs.
5. The bill provides that a carrier must require a provider receiving a referral to disclose to the patient whether the provider is an out-of-network provider.
6. The bill prohibits a health insurance carrier from charging any fee for the transfer of a patient between providers or for the transfer of patient records between providers unless the fee is disclosed and directly related to the costs associated with making that transfer of the patient or the patient's medical records.