Sec. 24515.
(1) Subject to subsection (3), the department shall prepare an annual report that, except as otherwise provided in subsection (2), includes, but is not limited to, the following information for the immediately preceding calendar year:
(a) The number of out-of-network billing complaints received by the department from enrollees or their authorized representatives.
(b) The number of complaints received by the department from enrollees or their authorized representatives, separated by provider specialty.
(c) For each health plan, the ratio of out-of-network billing complaints to the total number of enrollees in the health plan.
(d) Carrier network adequacy by provider specialty.
(e) The number of requests made to the department under section 24510(1).
(f) The number of requests for binding arbitration filed under section 24511(3).
(2) The department shall not consider insurance rates when preparing the report required under this section.
(3) By July 1 of the year following the year of the effective date of the amendatory act that added this article, and by every July 1 thereafter, the department shall prepare the report required under this section and provide the report to the senate and house of representatives standing committees on health policy and insurance. The department shall also post the report on the department's website.
History: Add. 2020, Act 234, Imd. Eff. Oct. 22, 2020
Popular Name: Act 368