RCW 48.49.003
305 words·~1 min read·
/wa/title-48/chapter-48-49/48-49-003A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)The legislature finds that:
(a)Consumers receive surprise bills or balance bills for services provided at nonparticipating facilities, by nonparticipating health care providers at in-network facilities, and by ground ambulance services organizations;
(b)Consumers must not be placed in the middle of contractual disputes between entities referenced in this section and health insurance carriers; and
(c)Facilities, providers, and health insurance carriers all share responsibility to ensure consumers have transparent information on network providers and benefit coverage, and the insurance commissioner is responsible for ensuring that provider networks include sufficient numbers and types of contracted providers to reasonably ensure consumers have in-network access for covered benefits.
(2)It is the intent of the legislature to:
(a)Ban balance billing of consumers enrolled in fully insured, regulated health plans and plans offered to public and school employees under chapter 41.05 RCW for the services described in RCW 48.49.020 and 48.49.200 and to provide self-funded group health plans with an option to elect to be subject to the provisions of this chapter;
(b)Remove consumers from balance billing disputes and require that nonparticipating providers and carriers negotiate nonparticipating provider payments in good faith under the terms of this chapter;
(c)Align Washington state law with the federal balance billing prohibitions and transparency protections in sections 2799A-1 et seq. of the public health service act (P.L. 116-260) and implementing federal regulations in effect on March 31, 2022, while maintaining provisions of this chapter that provide greater protection for consumers; and
(d)Provide an environment that encourages self-funded groups to negotiate payments in good faith with nonparticipating providers and facilities in return for balance billing protections.
[ 2024 c 218 s 2 ; 2022 c 263 s 6 ; 2019 c 427 s 1 .]
Notes:
Effective date — 2022 c 263: See note following RCW 43.371.100 .