Referred to the House Health Care & Wellness Committee on February 15, 2017
Substitute offered in the House on February 17, 2017 Establishes the balance billing protection act.
Addresses the charges for out-of-network health services.
Referred to the House Appropriations Committee on February 17, 2017
Amendment offered by Rep. Joe Schmick (Colfax) (R) on March 6, 2017 Clarifies that an out-of-network provider or facility may not balance bill a covered person for the specified health care services. Modifies the nonemergency services for which balance billing is prohibited by removing reference to invasive medical procedures and removing services by an out-of-network provider without the covered person's consent.
(2) Applies cost-sharing and dispute resolution provisions to health care facilities, in addition to health care providers. Requires carriers to calculate the in-network cost-sharing rate using the carrier's median (rather than average) contracted rate. Requires carriers to make payments directly to providers and facilities.
(3) Requires carriers to pay a billed amount of less than $300. Permits, when the billed amount is $300 or more, a carrier and out- of-network provider or facility to use mediation or, if the amount in dispute is $2000 or more, arbitration. Requires mediation expenses to be divided equally among the carrier, provider, and facility, if the amount in dispute is less than $2000.
The amendment passed by voice vote in the House on March 6, 2017
Referred to the House Rules Committee on June 21, 2017
Amendment offered by Rep. Eileen Cody (West Seattle) (D) on February 13, 2018 Striker amendment. Modifies requirements related to coverage of emergency services provided at an out-of-network emergency department.
? Regulates the practice of balance billing by out-of-network providers and facilities, and authorizes arbitration and mediation of balance billing disputes.
? Requires health care facilities, providers, and carriers to provide patients with information about network status.
? Requires carriers to treat hospitals and ambulatory surgical facilities as out-of- network if a certain percentage of providers who provide surgical or ancillary services do not contract with the same carrier.
The amendment passed by voice vote in the House on February 13, 2018
Amendment offered by Rep. Joe Schmick (Colfax) (R) on February 13, 2018 Requires the Washington State Institute for Public
Policy to study and make recommendations regarding balance billing
laws in other states. Removes provisions regarding: (a) banning
balance billing for certain services, (b) establishing a payment
methodology for out-of-network services, (c) establishing a dispute
resolution process, (d) disclosures to patients regarding balance
billing, (e) transparency regarding the network status of providers, and (f) enforcement.
The amendment failed by voice vote in the House on February 13, 2018