VA HB1714 | 2019 | Regular Session


Spectrum: Partisan Bill (Republican 1-0)
Status: Introduced on December 14 2018 - 25% progression
Action: 2018-12-14 - Referred to Committee on Commerce and Labor
Pending: House Commerce and Labor Committee
Hearing: Jan 17 in House Committee Room
Text: Latest bill text (Prefiled) [HTML]


Balance billing; emergency 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 the fair market value for the emergency services, less applicable cost-sharing requirements. The bill provides that direct payment from the health carrier to the out-of-network health care provider precludes the out-of-network health care provider from billing or seeking payment from the covered person for any other amount other than the applicable cost-sharing requirements. The measure defines fair market value as that price that is determined by considering the amounts billed to and accepted from health carriers or managed care plans by similar providers for comparable out-of-network emergency services in the community where the services were rendered, with the exclusion of amounts accepted by providers for patients covered by Medicare or Medicaid. The bill removes from the determination of whether a medical condition is an emergency medical condition the final diagnosis rendered to the covered person.

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Balance billing; emergency services.



2018-12-14HouseReferred to Committee on Commerce and Labor
2018-12-14HousePrefiled and ordered printed; offered 01/09/19 19102436D

Code Citations

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

Virginia State Sources

Bill Comments