Relating to: preventing surprise bills for emergency medical services and other items and services under health insurance policies and plans. (FE)

This bill aims to protect health insurance enrollees from unexpected medical bills by establishing rules for how insurance plans must handle emergency care and services provided by out-of-network providers. It requires insurance plans to cover emergency medical services without requiring prior authorization and ensures that cost-sharing amounts for out-of-network emergency care are no higher than what would apply for in-network care. Additionally, the bill mandates that plans pay out-of-network providers directly for emergency services and certain non-emergency services provided at in-network facilities, preventing patients from being billed for the difference between the out-of-network rate and the recognized amount. These provisions apply to defined network plans, preferred provider plans, and self-insured governmental plans that have networks of participating providers.