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House bars insurers from denying benefits after out-of-network primary-care referrals
Summary
House File 2434 would prohibit health insurers from denying a covered benefit or applying higher cost-sharing solely because the referral came from an out-of-network primary-care provider; the House adopted an exemption for certain prepaid plans and passed the bill unanimously (92-0).
Representative from Appanoose explained House File 2434 would stop insurers from denying coverage or charging higher cost-sharing solely because a covered benefit was referred by an out-of-network primary care provider. A floor amendment exempted certain prepaid plans (H8030); sponsors said the change protects patients and supports new direct-primary-care models.
Representative from Polk argued the bill would help patients avoid costly emergency visits when direct-primary-care clinicians need diagnostic services. The amendment passed and the House recorded 92 yeas, 0 nays; the chair agreed to the title.
