Sec. 24505. (1) For a nonemergency service provided by a nonparticipating provider with advanced notice, a nonparticipating provider may bill for any cost not covered by the nonemergency patient's health benefit plan, only if the nonemergency patient consents in writing and demonstrates satisfaction of all of the following criteria:

(a) At least 24 hours in advance, the nonemergency patient consents in writing to receive services from the nonparticipating provider.

(b) The consent shall not be obtained at the time of admission or at any time when the nonemergency patient is being prepared for surgery or any other procedure.

(c) At the time the consent is provided, the nonparticipating provider shall give the nonemergency patient a written estimate of the cost of care for services to be provided.

(d) The consent shall advise the nonemergency patient that he or she may elect to seek care from a participating provider or may contact his or her health benefit plan in order to arrange for those services to be provided by a participating provider at a lower cost.

(2) The notice required under subsection (1) must be in not less than 12-point type and in substantially the following form:

"Your health benefit plan may or may not provide coverage for all of the services you are scheduled to receive or the providers providing those services. You may be responsible for the costs of the services that are not covered by your health benefit plan.

We have conducted a good-faith search to determine whether your health benefit plan provides coverage for these services and, if so, to order these services from a provider that participates with your health benefit plan.

You have a right to request that the services be performed by a provider that participates with your health benefit plan.

I have received, read, and understand this notice.

_________________________________________________	________
(Patient's or patients' representative signature)	(Date)

_____________________________________________________________

(Type or print name of patient or patient's representative)".

(3) A nonparticipating provider shall complete the notice described in subsection (2) and, after completing the notice, obtain on the notice the signature of the nonemergency patient, or that patient's representative, acknowledging that the nonemergency patient, or that patient's representative, has received, has read, and understands the notice. A nonparticipating provider shall retain a copy of the notice required under this section for not less than 7 years.

(4) Section 24503 applies if a nonparticipating provider fails to comply with the requirements of this section by not obtaining written consent.

(5) The department may impose an administrative fine on a licensed provider for a violation of this section.

Enacting section 1. This amendatory act does not take effect unless Senate Bill No.____ or House Bill No.4459 (request no. 01850'19) of the 100th Legislature is enacted into law.