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House passes balance-billing and network-adequacy bill after lengthy floor debate
Summary
The Utah House passed the fifth substitute to House Bill 395, a package aimed at reducing surprise medical bills and improving insurer network transparency. The measure requires network adequacy demonstrations, updated online directories, direct payment to ER providers for emergency claims and a benchmark-based cap on balance billing.
The Utah House passed the fifth substitute to House Bill 395 on March 6, 2017, approving a set of measures intended to curb surprise medical bills and strengthen continuity of care for patients treated in emergency rooms.
Representative James A. Dunnigan, the bill sponsor, told colleagues the bill requires health plans to demonstrate adequate provider networks to the insurance commissioner and to post updated provider directories at least every 30 days. The substitute also requires plans to pay non‑network emergency providers at…
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