CAA 2021

This legislation provides rules and processes to protect health plan members from balance billing that may arise from non-network provider utilization that is out of the member's control. An example could be, an individual having surgery at an in-network facility, by an in-network physician, but the anesthesiologist, which they have no control over, is out of network.

This legislation requires health insurers and group health plans to make available negotiated rates for in-network providers and allowed amounts for out-of-network providers, derived from historical claims.