One-Pager Opposing HB 1236 and SB 1139: Allow Health Plans to Address Fraud

HB 1236 & SB 1139 change the prudent layperson standard to prohibit any use of a final emergency care diagnosis to identify potential fraud patterns. That doesn’t align with federal law or policies of other states.

Under the “prudent layperson standard,” a person gets to decide based on their own judgment if they are having a medical emergency. Essentially, if you believe you need emergency care, that can’t be questioned and that goes for your insurance coverage as well.

See the one-pager.

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