ATLANTA – State Representative Mark Newton (R-Augusta), chairman of the Special Committee on Access to Quality Health Care, today announced that Governor Brian Kemp signed House Bill 454 into law. Under HB 454, authored by Chairman Newton, a patient’s insurance will be required to reimburse health care providers at in-network rates for a certain time period if the health care provider is no longer in-network after the patient’s enrollment period.
“House Bill 454 protects patients who find out during the middle of an insurance plan year that their providers, whether they’re a doctor or hospital, are no longer covered in-network by their insurance,” said Chairman Newton. “Abrupt changes like these leave Georgians with the burden of choosing to pay out-of-pocket to continue care with their current provider or go without important treatments or medical procedures. This unfair practice is currently happening across our state and hurts patients, especially those who have scheduled surgeries and are left with this impossible choice. Extending the in-network rates will allow Georgians to continue to receive care at an affordable rate while they transition to a new doctor in a reasonable timeframe.”
Under HB 454, if an insurer included a health care provider during the open enrollment period but the health care provider later transitions to being out-of-network, insurers must reimburse the provider at the most recent in-network rates for 180 days after a provider’s contract is terminated or until the last day of a patient’s coverage, whichever is sooner. Additionally, during a public health emergency and for 150 days after the expiration of the public health emergency, HB 454 prohibits an insurer from terminating a provider from the insurer’s network and requires in-network reimbursement rates to be maintained. This bill is effective on January 1, 2022.
For more information on HB 454, please click here.
Representative Mark Newton represents the citizens of District 123, which includes portions of Columbia and Richmond counties. He was elected to the House of Representatives in 2016 and currently serves as Chairman on the Special Committee On Access to Quality Health Care and Vice Chair on the Health & Human Services Committee. He also serves on the Small Business Development, Transportation, Rules and Ways & Means committees.
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