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@@-LEGISLATURE+ST+A+TEMENTOF-THE-STATE-OF-IDAHO-Sixty-eighth-Legislature-Second-Regular-Session---2026-IN-THE-HOUSE-OF-REPRESENTATIVES-HOUSE-BILL-NO.-929-BY-WAYS-AND-MEANS-COMMITTEE-AN-ACT-1-RELATING-TO-HEALTH-CARE;-AMENDING-CHAPTER-18,-TITLE-41,-IDAHO-CODE,-BY-THE-2-ADDITION-OF-A-NEW-SECTION-41---1854,-IDAHO-CODE,-TO-DEFINE-TERMS,-TO-PRO---3-VIDE-FOR-CERTAIN-PROHIBITIONS-AND-DUTIES-OF-HEALTH-CARRIERS-AND-HEALTH-4-CARE-PROVIDERS-WITH-REGARD-TO-CERTAIN-COVERED-PERSONS-WHO-PAY-OUT-OF-5-FOR-HEALTH-CARE-SERVICES;-AND-DECLARING-AN-EMERGENCY-AND-PROVID---6-ING-AN-EFFECTIVE-DATE.-7-Be-It-Enacted-by-the-Legislature-of-the-State-of-Idaho:-8-SECTION-1.-That-Chapter-18,-Title-41,+PURPOSE+RS33754+/+H0929+This+bill+amendsIdaho-Code,-be,-and-the-same-is-9-hereby-amended-by-the-addition-thereto-of-a-NEW-SECTION-,-to-be-known-and-des---10-ignated-as-Section-41---1854,-Idaho-Code,-and-to-read-as-follows:-1-1-41---1854.-HEALTH-CARE-----CASH-PRICE-FOR-SERVICES.-(1)-As-used-in-this-12-section,-the-terms-"covered-person,"-"health-benefit-plan,"-"health-care-13-provider,"-"health-care-services,"-"health-carrier,"-and-"medically-nec---14-essary"-shall-have-the-same-meanings-as-provided-in+Code+to+addsection-41---5903,-Idaho-15-Code.-16-(2)-A+41-1854,+prohibitinghealth-carrier-may-not-prohibit-a-health-care-provider+carriersfrom-of---17+preventing+providers+from+offering-a-covered-person-the-option-of-paying-the-provider'sdiscountedcash-18-price+prices+to+insured+individualsforhealthcareservices.-For-the-purposes-of-this-subsection,-"dis---19-counted-cash-price"-means-the-charge-that-applies-to-a+It+allowscovered-person-who-20-pays-cash-for-a-health-care-service.-With-respect-to-a-hospital,-the-dis---21-counted-cash-price-shall-have-the-same-meaning-as-provided-in-45-CFR-180.20-if-22-the-hospital-has-a-discounted-cash-price.-It-does-not-mean-the-amount-charged-23-to-individuals-who-are-eligible-for-free-care-or-are-eligible-for-the-amounts-24-charged-pursuant-to-a-hospital's-financial-assistance-policy.-25-(3)-A-covered-person-may-choose+peopletopay-out-of-for-a-health-care-26-service-from-a-health-care-provider.-27-(4)-If-a-covered-person-obtains-a-medically-necessary-health-care-ser---28-vice-covered-by-such-person's-health-benefit-plan-and-negotiates-for-a-price-29+out-of-pocket+at+negotiated+rateslowerthanthe+plan's+averageallowed-amount-established+amount,+with+such+payments+counting+toward+deductibles+and+annual+out-of-pocket+maximums+upon+submission+of+required+documentation.+Providers+must+accept+cash+payments+as+full+settlement.+Exemptions+apply+to+specified+plans+like+dental-only+,+Medicaid,+and+short-term+insurance.+Ef+fective+July+1,+2026.+FISCAL+NOTE+This+legislation+causes+no+increase+or+decrease+in+revenue,+or+additional+expenditure+of+funds+at+the+state+or+local+level+of+government;+therefore,+this+legislation+has+no+fiscal+impact.+Contact:+Representative+Chris+Bruce+(208)+332-1000+Representative+Erin+M.+Bingham+(208)+332-1000+DISCLAIMER:+This+statement+of+purpose+and+fiscal+note+ar+e+a+mer+e+attachment+to+this+bill+and+pr+epar+edby-the-benefit-plan,+a+pr+oponent+of+the+bill.+It+is+neither+intendedas-provided-30-to-the-covered-person-upon-request,-and-the-covered-person-pays-out-of-31-for-the-health-care-service,-the-amount-of-the-out---of---cost-shall-be-32-counted-toward-the-covered-person's-out---of---deductible-and-annual-33-maximum-out---of---expense-if-the-requirements-of-this-section-are-met.-34-(5)-A-health-carrier-that-receives-the-documentation-described-in-35-subsection-(6)-of-this-section-shall-count-the-full-amount-that-the-cov---36-ered-person-paid-out-of-toward-the-deductible-and-annual-maximum-37-out---of---expense-if:-38-(a)-The-health-care-service-is-covered-under-the-health-benefit-plan-of-39-the-covered-person;-and-40--2-(b)-The-covered-person-negotiated-for-a-lower-cost-for-the-health-care-1-service-than-the-allowed-amount-established-by-the-covered-person's-2-health-benefit-plan-for-that-covered-health-care-service.-3-(6)-A-covered-person-shall-electronically-send-documentation-to-the-4-health-carrier-that-provides-the-following-information:-5-(a)-The-health-care-services-the-covered-person-or-patient-received-and-6-the-name-of-the-health-care-provider-and-contact-information;-7-(b)-The-final-bill-or-statement-for-the-health-care-services;-and-8-(c)-The-negotiated-cost-of-the-health-care-service-that-the-covered-per---9-son-received-and-documentation-that:-10-(i)-The-covered-person-paid-out-of-for-the-health-care-ser---1-1-vices-received;-and-12-(ii)-The-health-care-provider-is-not-making-a-claim-against-the-13-health-carrier-for-payment-of-the-health-care-service-provided-to-14-the-covered-person-or-patient.-15-(7)-The-health-care-provider-shall-accept-the-discounted-cash-payment-16-from-the-covered-person-as-payment-in-full-and-shall-not-bill-the-covered-per---17-son-or-the-health-carrier+an+expr+ession+of+legislative+intent+nor+intendedforany-balance-between-the-amount-collected-from-18-the-covered-person-and-the-billed-charge-for-the-service-by-the-provider.-19-(8)-The-amount-of-the-out---of---cost-shall-be-attributed-to-the-20-in---network-deductible-and-annual-maximum-out---of---expense-if-the-21-provider-was-an-in---network-provider-and-to-the-out---of---network-deductible-and-22-annual-maximum-out---of---expense-if-the-provider-was-an-out---of---network-23-provider.-24-(9)-The-amount-counted-toward-an-applicable-out---of---deductible-25-and-annual-maximum-out---of---expense-shall-not-exceed-the-total-amount-26-that-the-covered-person-is-required-to-pay-out-of-during-a-contractu---27-ally-agreed-on-period-of-time-for-health-care-services-that-are-included-un---28-der-the-health-benefit-plan-of-the-covered-person-and-shall-not-carry-over-29-once-a-new-contract-or-agreement-period-for-the-plan-begins.-30-(10)-The-provisions-of-subsections-(4)-through-(9)-of-this-section-shall-31-not-apply-to:-32-(a)-A-plan-that-provides-coverage:-33-(i)-Only-for-a-specified-disease-or-diseases;-34-(ii)-Only-for-accidental-death-or-dismemberment;-35-(iii)-Only-for-dental-or-vision-care;-36-(iv)-Under-an-individual-limited-benefit-policy;-37-(v)-For-a-hospital-confinement-indemnity-policy;-38-(vi)-For-disability-income-insurance-or-a-combination-of-acci---39-dent---only-and-disability-income-insurance;-or-40-(vii)-As-a-supplement-to-liability-insurance;-41-(b)-Any-programs-administered-by-the-Idaho-department-of-health-and-42-welfare-through-the-state-medicaid-program-under-title-XIX-of-the-fed---43-eral-social-security-act,-as-amended;-44-(c)-A-medicare-supplemental-policy-as-defined-by-section-1882(g)(1)-of-45-the-social-security-act;-46-(d)-Worker's-compensation-insurance-coverage;-47-(e)-Medical-payment-insurance-issued-as-part-of-a-motor-vehicle-insur---48-ance-policy;-49--3-(f)-A-long---term-care-policy,+use+outside+of+the+legislative+pr+ocess,including-a-nursing-home-fixed-indemnity-1-policy,-unless-a-determination-is-made-that-the-policy-provides-bene---2-fit-coverage-so-comprehensive-that-the-policy-meets-the-definition-of-a-3-health-benefit-plan;-or-4-(g)-Short---term-health-insurance-issued-on-a-nonrenewable-basis-with-a-5-duration-of-six-(6)-months-or-less.-6-(11)-Nothing-in-this-section-shall-be-construed-to-waive-or-override-7-prior-authorization,-medical-necessity,-or-utilization-management-require---8-ments-under-the-health-benefit-plan.-9-SECTION-2.-An-emergency-existing-therefor,-which-emergency-is-hereby-10-declared-to-exist,-this-act-shall-be-in-full-force-and-effect-on-and-after-1-1-January-1,-2027.-12+judicial+r+eview+(Joint+Rule+18).+Statement+of+Purpose+/+Fiscal+Note+Bill+SOP/FN+INTRODUCED:+03/18/2026,+9:25+AM
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