AB 819

This bill specifies that discounts for prompt payment do not violate prohibitions on reducing certain fees for health care services. Under current state law, a health care provider is prohibited from reducing or offering to reduce coinsurance or a deductible of an individual covered under a health insurance policy that is required under the terms of the policy, unless paying the amount would be an undue financial hardship to the individual. Under this bill, a discount offered by a health care provider to an individual covered under a health insurance policy is exempt from that prohibition if the discount satisfies all of the following: the health care provider offers the discount for prompt payment without regard to the issuer of the individual’s health insurance policy or the reason for the individual seeking the product or service; the amount of the discount bears a reasonable relationship to the amount that the health care provider avoids in collection costs by prompt payment but is no more than 15 percent of the fee owed; the health care provider notifies the issuer of the health insurance policy of the prompt payment discount policy but, unless required by law, does not publicly advertise the discount; the health care provider does not provide the discount prior to the service being scheduled or outside the provider’s ordinary course of dealing with patients; and the health care provider does not shift the cost of the discount to any other payer or, except as allowed by law, include the discount in an agreement with a third-party payer. Health insurance policies are referred to as disability insurance policies in the bill.