AB349

Existing law creates the Public Employees' Benefits Program to provide group life, accident or health insurance to certain public employees, state officers and members of the Legislature in this State. (NRS 287.043) Existing law also prescribes a procedure to determine the amount that a third party which provides health coverage to a person, including the Public Employees' Benefits Program, is required to pay to an out-of-network hospital, independent center for emergency medical care or other provider of health care for medically necessary emergency services rendered to that person. (NRS 439B.700-439B.760) Section 5 of this bill establishes maximum rates that hospitals, independent centers for emergency medical care and surgical centers for ambulatory patients may charge for goods and services when provided to a patient who is covered by the Program or a local government employer that elects to be subject to those maximum rates. Those maximum rates differ depending on whether the facility is an in-network facility or an out-of-network facility. Section 5 authorizes the Division of Health Care Financing and Policy of the Department of Health and Human Services to increase those maximum rates if: (1) the Division determines that health care facilities in this State are experiencing financial hardship due to a decrease in the rates of reimbursement provided under Medicaid; and (2) the Interim Finance Committee approves the increase. Section 11 of this bill authorizes th