Can a medical practice bill for services performed at another facility without ancillary agreements in place?
A. According to HB 1966 (Act 1157), which was enacted as LRS 22:250.41 through 250.47, if a facility-based non-contracted provider provides health care services in a base health care facility to an enrollee or insured and files a claim with a health insurance issuer for such facility based services, the insurer shall provide the provider with an explanation of benefits as to any payment determination thereof. This Act, also referred to as the Health Care Consumer Billing and Disclosure Protection Act, became effective January 1, 2004. For a complete copy of this bill, go to www.legis.state.la.us, pull up the 2003 regular legislative session, and enter the bill information as provided above.
