H.B. 136

1

DISCOUNTS ON MEDICAL HEALTH CARE
2 2007 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Larry B. Wiley
5 Senate Sponsor: ____________
6
7 LONG TITLE
8 General Description:
9 This bill enacts a new part in the Medical Assistance Act of the Health Code which
10 limits the amount a health care provider may charge an uninsured individual.
11 Highlighted Provisions:
12 This bill:
13 . defines terms; and
14 . beginning July 1, 2007, limits the amount that a health care provider may charge an
15 uninsured individual for health care services.
16 Monies Appropriated in this Bill:
17 None
18 Other Special Clauses:
19 None
20 Utah Code Sections Affected:
21 ENACTS:
22 26-18-601, Utah Code Annotated 1953
23 26-18-602, Utah Code Annotated 1953
24
25 Be it enacted by the Legislature of the state of Utah:
26 Section 1. Section 26-18-601 is enacted to read:
27 Part 6. Billing Practices for Uninsured Individuals

28 26-18-601. Definitions.
29 For purposes of this part:
30 (1) "Health care provider" includes:
31 (a) health care facilities licensed under Chapter 21, Health Care Facility Licensing and
32 Inspection Act; and
33 (b) the following professionals licensed under Title 58, Occupations and Professions:
34 (i) a dentist;
35 (ii) a physician;
36 (iii) an osteopathic physician;
37 (iv) a physician's assistant; and
38 (v) an advanced practice registered nurse.
39 (2) "Uninsured person" means any individual or group of individuals who are not
40 enrolled in or do not receive benefits directly or indirectly from:
41 (a) health care insurance as defined in Section 31A-1-301 ;
42 (b) Medicare;
43 (c) the state Medicaid program; or
44 (d) any other state sponsored or funded medical assistance program.
45 Section 2. Section 26-18-602 is enacted to read:
46 26-18-602. Health care billing practices.
47 (1) (a) Beginning July 1, 2007, a health care provider may not require reimbursement
48 from an uninsured patient in an amount greater than:
49 (i) 15% above the Medicare established reimbursement for the same coded service; and
50 (ii) the interest rates permitted by Subsection (3).
51 (b) The limitation on reimbursement in Subsection (1)(a) applies in any legal action for
52 collection against the uninsured individual.
53 (2) Health care providers shall inform uninsured patients of the limit on reimbursement
54 imposed by this section at the time services are given and when sending a billing statement.
55 (3) (a) Except as provided in Subsection (3)(b), interest may not be imposed on an
56 uninsured individual's unpaid account:
57 (i) for 30 days if the unpaid amount is less than $100;
58 (ii) for 60 days if the unpaid amount is between $100 and $250; and

59 (iii) for 90 days if the unpaid amount is over $250.
60 (b) The prohibition against charging interest in Subsection (3)(a) does not apply if an
61 uninsured patient does not make reasonable efforts to make partial payments.




Legislative Review Note
as of 1-8-07 11:52 AM

Office of Legislative Research and General Counsel