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Bill

A 3488

Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery

2025 Regular Session Introduced by Marianne Buttenschon and 3 co-sponsors

Requires insurers or providers to notify insured patients that an out-of-network physician may be involved in their procedure, with potential cost-sharing and charges.

REFERRED TO INSURANCE
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WeVote Research Nonpartisan
Bill Summary · A 3488

Bill A 3488 — Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery

Overview

A 3488 would require insurers or providers to notify insured patients that an out-of-network physician may be involved in their medical procedure, test, or surgery. The bill was introduced on January 28, 2025 and referred to the Insurance Committee.

What the bill would do

  • Mandate notification to insured individuals that an out-of-network physician may be involved in a planned or performed medical procedure, test, or surgery.
  • Translation: patients would be informed in advance that an out-of-network clinician could participate in their care, potentially affecting cost-sharing and billed charges.

Key provisions (as described)

  • Notification requirement: Insureds must be informed that an out-of-network physician may be used in connection with their procedure, test, or surgery.
  • Scope: The notification appears to cover situations where an out-of-network physician could be involved, whether through referral, hospital-based services, or other care arrangements.
  • Compliance: The bill would establish expectations for how and when the notification is provided, though the exact mechanisms (e.g., timing, format, or delivery method) are not specified in the available information.

Who would be affected

  • Insured patients: Primary recipients of the notification, potentially impacting their understanding of network status and potential cost implications.
  • Healthcare providers and facilities: May be responsible for delivering or ensuring the notification is provided to patients.
  • Health insurers: Likely to administer the notification process and ensure compliance with the requirement.
  • Out-of-network physicians: Indirectly affected by the requirement to inform patients who might see them through care arrangements.

Procedural and timeline aspects

  • Status: Referred to the Insurance Committee.
  • Introduction date: January 28, 2025.
  • Legislative actions: The bill’s action history lists “REFERRED TO INSURANCE” twice on the same date, indicating initial committee referral.

Sponsors

  • Primary sponsor: Erik Dilan
  • Cosponsors: Kwani O'Pharrow, Rebecca Kassay, Marianne Buttenschon

Related bills and companion

  • Related (prior-session) A bills: A 7235, A 635, A 495, A 8091, A 9773, A 10124, A 2792, A 2765, A 1983, A 2663
  • Companion: S 4012 (listed as a companion in the Senate)

Potential impact and considerations

  • Transparency: Aims to reduce surprise billing by ensuring patients are aware that an out-of-network physician may participate in their care.
  • Cost considerations: While the bill focuses on notification, patients could be better prepared for potential out-of-network charges and balance billing scenarios.
  • Implementation: Details (timing, delivery method, and exceptions) are not provided in the available information and would be crucial for assessing practical impact.

This summary reflects the bill’s currently available information. For a complete understanding, the full text and any fiscal notes or amendments would be helpful once released.

Compiled from official sources — confirm details with the bill’s official record.

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