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SB 261 - This act modifies the definition of "unanticipated out-of-network care" to no longer require that the patient shall present at the in-network facility "with an emergency medical condition". The act also specifies that "unanticipated out-of-network care" shall include a referral or transfer from an in-network provider to an out-of-network provider in a situation where the only provider capable of rendering life-saving or life-sustaining treatment to the patient is an out-of-network provider. Lastly, the act provides that in-network deductible, "co-pay, coinsurance," and out-of-pocket maximum cost-sharing requirements shall apply to claims for unanticipated out-of-network care, rather than the in-network deductible and out-of-pocket requirements alone. This act is identical to SB 944 (2020), and similar to HB 2417 (2020). ERIC VANDER WEERD
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