AN ACT Relating to emergency health care services balanced billing; creating a new section; and providing an expiration date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

(a) The scope of the balance billing issue, including an estimate of the number of consumers affected by balance billing, the average billed charges, and the average amount paid by the consumers;

(b) The impact of narrow networks on the frequency of balance billing;

(c) Ways to eliminate balance billing for health services;

(d) Whether a prohibition against balance billing for emergency services should apply to services provided by nonparticipating providers outside of the emergency department; and

(e)(i) Payment methodologies for paying nonparticipating providers for health services, including:

(A) Any payment methodologies required by federal law;

(B) Direct payment of nonparticipating providers; and

(C) Ways to resolve payment disputes between issuers and nonparticipating providers.

(ii) When making recommendations on payment methodologies under this subsection (1)(e), the work group shall consider the effects of each recommendation on payment rates for participating providers, the ability of issuers to maintain adequate networks of providers, and overall costs to consumers, issuers, providers, and hospitals.

(2) The work group must, at a minimum, consist of representatives of the following groups:

(a) Providers of health services;

(b) Issuers;

(c) Hospitals; and

(d) Consumers.

(3) The insurance commissioner shall convene the first meeting of the work group no later than July 1, 2016.

(4) The insurance commissioner shall report the recommendations of the work group to the appropriate committees of the legislature no later than December 1, 2016.

(5) This section expires July 31, 2017.

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