Assignment of Benefits Sample Legislation

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Requires insurers to honor assignment of benefits and pay claims filed by out-of-network emergency providers directly to those providers.

 

Requires that insurers honor assignment of benefits to hospital-based and on-call out-of network physicians who agree to accept it in exchange for not balance billing patients. Insurers are required to pay these physicians the greater of 140% of the average contract rate paid for that service or the amount the physician accepted for that service in January 2010, with an annual adjustment for inflation.

 

A bill passed by the Florida legislature requiring insurers to honor assignment of benefits to emergency care providers (Section 4).  The law was subsquently amended to expand this requirement to all providers.

 

Allows patients to assign benefits to any provider.  Insurers must directly pay physicians when they possess a written assignment of benefits.

 

2004 model state legislation on assignment of benefits developed by the AMA.

 

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