2114-S.E AMH SHMK MORI 121

ESHB 2114 - H AMD TO H AMD (H-4762.3/18) 1017

By Representative Schmick

NOT ADOPTED 02/13/2018

    On page 1, line 6 of the striking amendment, after "to" strike "ban" and insert "study banning"

    On page 1, line 10 of the striking amendment, after "intends" insert "to study ways"

    On page 1, at the beginning of line 12 of the striking amendment, strike "requiring that payments for noncontracted providers" and insert "whether payments for noncontracted providers should"

    On page 2, line 13 of the striking amendment, after ""Balance" strike "bill" means a bill sent" and insert "billing" means the practice of sending a bill"

    On page 10, line 4 of the striking amendment after "deductibles" strike ", ((and" and insert "((, and"

    On page 10, beginning on line 23 of the striking amendment, after "health))" strike "as provided in sections 4 through 15 of this act"

    On page 11, after line 21 of the striking amendment, insert the following:

"NEW SECTION. Sec. 5.  (1) The Washington state institute for public policy shall study ways in which other states have addressed the issue of balance billing.  The study shall evaluate the impact of laws affecting balance billing in other states on:

    (a) The affordability of health care services to consumers, including both premium costs and out-of-pocket expenses;

    (b) The ability of health carriers to maintain adequate provider networks; and

    (c) The ability of providers to be adequately and fairly compensated for rendered services.

    (2) The Washington state institute for public policy shall make recommendations regarding:

    (a) Whether and to what extent balance billing should be prohibited, including the types of services to which any restriction should apply;

    (b) Methodologies to calculate health carrier reimbursement for services rendered by out-of-network providers and methodologies to resolve payment disputes between health carriers and out-of-network providers; and

    (c) Ways in which to increase transparency to consumers on the costs of care, including balance billing.

    (3) The Washington state institute for public policy shall report its findings and recommendations to the appropriate committees of the legislature by December 1, 2018."

    Renumber the remaining sections consecutively and correct any internal references accordingly.

    On page 11, beginning on line 22 of the striking amendment, strike all of sections 5 through 22

    Renumber the remaining sections consecutively and correct any internal references accordingly.

    On page 25, line 27 of the striking amendment, after "Sections 4" strike "through 16" and insert "and 5"

    On page 25, line 30 of the striking amendment, after "through" strike "21 and 23" and insert "3"

EFFECT:   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.

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