HB2005 S H&HR AM #1

Dellinger 7965


The Committee on Health and Human Resources moved to amend the bill by striking out everything after the enacting clause and inserting in lieu thereof the following:



16-29B-24. Reports required to be filed.

(a) A covered facility, within one hundred twenty 120 days after the end of its fiscal year, unless an extension be granted by the authority, shall file with the authority its annual financial report prepared by an accountant or auditor.

(b) A covered facility, if applicable by legislative rule, shall submit upon request of the authority but at least annually:

(1) A statement of charges for all services rendered, except a behavioral health facility shall submit its gross rates for its top thirty 30 services by utilization;

(2) The Health Care Authority Financial Report, through the Uniform Reporting System;

(3) The current Uniform Bill form in effect for inpatients. This data is not subject to the provisions of subsection (f), section twenty-five of this article 16-29B-25(f) of this code.

(c) The authority may request from a covered facility, except hospitals, the information from subsection (a) and (b) from its related organization.

(d) A home health agency shall annually submit a utilization survey.

(e) A summary of every contract or an amendment to an existing contract for the payment of patient care services between a purchaser or third party payor and a hospital shall be filed by the hospital.

(e) (f) A covered facility failing to submit a report to the authority shall be notified by the authority and, if the failure continues for ten 10 days after receipt of the notice, the delinquent facility organization is subject to a penalty of $1,000 for each day thereafter that the failure continues.

33-2-24. Authority of Insurance Commissioner to enforce No Surprises Act; administrative penalties; injunctive relief; regulatory assistance of other agencies; rulemaking; effective date.

(a) The Insurance Commissioner shall enforce the applicable provisions of the No Surprises Act (H.R. 133, Public Law 116-260) against health insurers, medical providers, and health care facilities. 

(b) Whenever the Insurance Commissioner believes, from evidence satisfactory to him or her, that any insurer, medical provider, or health care facility is violating the applicable provisions of the No Surprises Act, the Commissioner may assess a fine, not to exceed $10,000 per violation, after notice and hearing pursuant to 33-2-13 of this code.  In addition to the administrative penalty available in this subsection, the Insurance Commissioner may cause a complaint to be filed in the appropriate court of this state seeking to enjoin and restrain the insurer, medical provider, or health care facility from continuing the violation or engaging therein or doing any act in furtherance thereof.

(c) The Insurance Commissioner may, at his or her discretion, seek assistance from any other state government agency regarding regulatory enforcement of this section against medical providers or health care facilities.  The Insurance Commissioner may also call upon the Attorney General for legal assistance and representation as provided by law.

(d)  The Insurance Commissioner may propose rules for legislative approval in accordance with 29A-3-1 et seq. of this code to effectuate the provisions of this section. 

(e) The provisions of this section shall become effective January 1, 2022.