The bill clarifies that an intermediary between a health insurance carrier and health care provider is a "person or entity" for purposes of complying with health care contract disclosure requirements.
Each health care provider who provides outpatient health care or treatment is required to disclose to a patient the right to request the nondiscounted charge for the care or treatment and, upon request, make that information available before the scheduling of care or treatment.
Each health insurance carrier shall:
Provide notice to covered persons advising them of therelationship with the third-party administrator, the policyholder, and the insurance carrier;
Disclose to the covered person all charges, fees, andcommissions paid to the third-party administrator; and
Prohibit a third-party administrator from altering a healthcare provider's charges or adding charges to any of the insurance claims submitted by a health care provider.
Each carrier must disclose to each covered person any charges for administrative costs that are in addition to the charges for the care or services provided by the health care provider.
The bill makes technical corrections to the law concerning the contractual relationship with a third-party intermediary. Current law uses the term "intermediary" when the proper entity is "third-party administrator".
