Imposing disclosure and billing requirements for certain health care providers, creating an arbitration process, and granting rule-making authority. This bill creates disclosure, notice, billing, and arbitration requirements for the situation in which an enrollee in a defined network or preferred provider plan
(“plan”) may receive services from a health care provider that is not in the plan’s network. Under the bill, a plan must annually provide to enrollees a directory of providers and a list of health care facilities that are in its network. The bill also
requires that a provider who is not in the network of the enrollee’s plan but is providing a service at an in-network health care facility must disclose that
information to the enrollee, provide the enrollee a good faith estimate of the cost of services the enrollee may be responsible for, and inform the enrollee of the availability of arbitration to settle disputes over the cost of services. The health care
facility may opt to provide the notice for the provider.