§ 20-3117 — Dispute resolution; notice of rights

A. The department in conjunction with the appropriate health care boards shall prescribe the notice outlining an enrollee's rights to dispute surprise out-of-network bills under this article.

B. Health insurers shall include the notice prescribed pursuant to subsection A of this section in each explanation of benefits or other similar claim adjudication notice that is issued to enrollees and that involves covered services provided by a noncontracted health care provider. This subsection applies only to claims that are not subject to an independent dispute resolution pursuant to the No Surprises Act (P.L. 116-120; 134 Stat. 2758; 42 United States Code section 201).

C. If an enrollee contacts a health care provider, a provider's representative or a billing company regarding a dispute involving a surprise out-of-network bill that is not subject to an independent dispute resolution pursuant to the No Surprises Act (P.L. 116-120; 134 Stat. 2758; 42 United States Code section 201), the health care provider, the provider's representative or the billing company shall provide written notice as prescribed in subsection A of this section to the enrollee of the dispute resolution process.

D. The department shall post on its website information for health care consumers regarding what constitutes a surprise out-of-network bill, how to try to avoid a surprise out-of-network bill and how the dispute resolution process may be used to resolve a surprise out-of-network bill.