- District 12
The ability of insured dependents and other insured members to receive confidential sensitive health care services without the knowledge of the insured policyholder is greatly impeded through traditional billing processes utilized by health insurers. The most frequent form used is an explanation of benefit (EOB) sent to the policyholder after anyone covered under the policy receives care. The lack of confidentiality for sensitive health care services significantly impacts young adults between the ages of 18-26 years of age that are on their parents’ health insurance plans and adults covered as dependents under abusive spouse or family member’s plans. This results in dependents simply avoiding necessary health care for these sensitive health care services. This Act (1) requires health carriers to use a common summary of payment form, developed by the Department of Insurance, in collaboration with health insurers, for defined sensitive health care services; (2) prohibits the health carriers from specifying any defined sensitive health care services in the form; (3) allows health carriers to address the form to the insured member; (4) allows insured member to choose their preferred method of receiving said form; (5) allows the insured member to opt-out of receiving the form when there is no payment liability for the visit or service provided; (6) requires the Department of Insurance and Division of Public Health to educate health care providers and health carriers on the new law. The effective dates for guidance and education requirement are 3 and 6 months, respectively, after enactment.
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