A bill for an act relating to insurance coverage for emergency services, reimbursements for out-of-network providers, and complicating factors.

Summary

The bill forces health plans to cover emergency services delivered by out-of-network doctors, paying the higher of the median in‑network rate or 150% of the Medicare fee schedule. It also creates a limited process for additional payment when a service involves a “complicating factor,” including a 30‑day denial window and optional binding arbitration. Costs of arbitration are split between the insurer and the provider.

AI-generated summary — may be incomplete or inaccurate. Verify against the official bill text.

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