Senate File 2381 S-5039 Amend Senate File 2381 as follows: 1 1. Page 1, line 4, by striking < 514M.1 > and inserting < 514M > 2 2. Page 1, by striking lines 23 through 35. 3 3. Page 2, by striking lines 1 through 17. 4 4. Page 2, line 18, by striking < 5. > and inserting < 2. > 5 5. Page 2, after line 22 by inserting: 6 < 3. “Covered benefits” or “benefits” means health care 7 services that a covered person is entitled to under the terms 8 of a health benefit plan. > 9 6. Page 2, by striking lines 23 and 24 and inserting: 10 < 4. “Covered person” means a policyholder, subscriber, 11 enrollee, or other individual participating in a health benefit 12 plan. > 13 7. Page 2, by striking lines 25 through 32. 14 8. Page 2, line 33, by striking < 9. > and inserting < 5. > 15 9. Page 3, by striking lines 1 and 2 and inserting: 16 < 6. “Health benefit plan” means a policy, contract, 17 certificate, or agreement offered or issued by a health carrier 18 to provide, deliver, arrange for, pay for, or reimburse any of 19 the costs of health care services. > 20 10. Page 3, line 3, by striking < 11. > and inserting < 7. > 21 11. Page 3, by striking lines 12 and 13 and inserting: 22 < 8. “Health care services” means services for the diagnosis, 23 prevention, treatment, cure, or relief of a health condition, 24 illness, injury, or disease. > 25 12. Page 3, by striking lines 14 and 15 and inserting: 26 < 9. a. “Health carrier” means an entity subject to the 27 insurance laws and regulations of this state, or subject 28 to the jurisdiction of the commissioner, including an 29 insurance company offering sickness and accident plans, a 30 health maintenance organization, a nonprofit health service 31 corporation, a plan established pursuant to chapter 509A 32 for public employees, or any other entity providing a plan 33 of health insurance, health care benefits, or health care 34 services. 35 -1- SF 2381.3420 (1) 90 nls/ko 1/ 4 #1. #2. #3. #4. #5. #6. #7. #8. #9. #10. #11. #12.

b. For purposes of this chapter, “health carrier” does not 1 include an entity providing any of the following: 2 (1) Coverage for accident-only, or disability income 3 insurance. 4 (2) Coverage issued as a supplement to liability insurance. 5 (3) Liability insurance, including general liability 6 insurance and automobile liability insurance. 7 (4) Workers’ compensation or similar insurance. 8 (5) Automobile medical-payment insurance. 9 (6) Credit-only insurance. 10 (7) Coverage for on-site medical clinic care. 11 (8) Other similar insurance coverage, specified in 12 federal regulations, under which benefits for medical care 13 are secondary or incidental to other insurance coverage or 14 benefits. 15 c. For purposes of this chapter, “health carrier” does not 16 include an entity providing benefits under a separate policy 17 including any of the following: 18 (1) Limited scope dental or vision benefits. 19 (2) Benefits for long-term care, nursing home care, home 20 health care, or community-based care. 21 (3) Any other similar limited benefits as provided by the 22 commissioner by rule. 23 d. For purposes of this chapter, “health carrier” does not 24 include an entity providing benefits offered as independent 25 noncoordinated benefits including any of the following: 26 (1) Coverage only for a specified disease or illness. 27 (2) A hospital indemnity or other fixed indemnity 28 insurance. 29 e. For purposes of this chapter, “health carrier” does 30 not include an entity providing a Medicare supplemental 31 health insurance policy as defined under section 1882(g)(1) 32 of the federal Social Security Act, coverage supplemental to 33 the coverage provided under 10 U.S.C. ch. 55, and similar 34 supplemental coverage provided to coverage under group health 35 -2- SF 2381.3420 (1) 90 nls/ko 2/ 4

insurance coverage. > 1 13. Page 3, line 16, by striking < 14. > and inserting < 10. > 2 14. Page 3, line 18, by striking < 15. > and inserting < 11. > 3 15. Page 3, line 34, after < individuals. > by inserting 4 < A health care provider may satisfy the requirements of this 5 paragraph by complying with the centers for Medicare and 6 Medicaid services of the United States department of health and 7 human services hospital price transparency final rule published 8 in the federal register on November 22, 2023. > 9 16. Page 4, by striking lines 6 through 21 and inserting: 10 < c. (1) Prior to the provision of a scheduled health 11 care service, a health care provider shall inform all covered 12 persons and uninsured individuals of the right of the covered 13 person or uninsured individual to pay for a health care service 14 via the discounted cash price. The notice may be provided 15 electronically, verbally, in writing, or posted at the physical 16 location of the health care provider. 17 (2) Prior to the provision of a scheduled health care 18 service, a health care provider shall inform a covered person 19 that the covered person may qualify for a deductible credit 20 if the covered person pays the discounted cash price for the 21 health care service and if the discounted cash price is below 22 the average allowed amount paid by the health carrier to 23 network providers for a comparable health care service. The 24 notice may be provided electronically, verbally, in writing, or 25 posted at the physical location of the health care provider. > 26 17. Page 4, after line 27 by inserting: 27 < e. A health carrier shall not enter into a contract with a 28 health care provider that prohibits the health care provider 29 from offering a discounted cash price below the contracted 30 rates the health care provider has with a health carrier, or 31 that prohibits the health care provider from disclosing the 32 health care provider’s discounted cash price under paragraph 33 “b” . > 34 18. Page 4, line 28, by striking < e. > and inserting < f. > 35 -3- SF 2381.3420 (1) 90 nls/ko 3/ 4 #13. #14. #15. #16. #17.

19. Page 4, line 30, by striking < health care provider > and 1 inserting < pharmacist > 2 20. Page 4, by striking line 32 and inserting < point the 3 pharmacist fills a prescription drug > 4 21. Page 4, line 34, by striking < f. > and inserting < g. > 5 22. Page 7, by striking lines 5 through 12. 6 23. Page 8, by striking lines 4 through 35. 7 24. Page 9, by striking lines 1 and 2 and inserting: 8 < 10. This chapter shall not be construed to prohibit a 9 health care > 10 25. Page 9, line 9, by striking < 12. > and inserting < 11. > 11 26. Page 9, line 26, by striking < 2025 > and inserting < 2026 > 12 27. Title page, by striking line 2 and inserting < services. > 13 ______________________________ JEFF EDLER -4- SF 2381.3420 (1) 90 nls/ko 4/ 4 #19. #20. #21. #22. #23. #24. #25. #26. #27.