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HB 1271

BillStateINHouse
Payment of health claims.
About This Bill
Latest Action · Mar 4, 2026
Public Law 88
Session
2026
Introduced
Jan 6, 2026
Primary Sponsor
Julie McGuire· author

Summary

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Requires a hospital to: (1) disclose information concerning payment assistance programs; (2) post signs concerning the programs in specified locations of the hospital; and (3) make information concerning the programs available to individuals through the hospital's patient portal. Requires a hospital to make a reasonable effort to notify individuals of available payment assistance programs before beginning a collection action against the individual. Prohibits the use of downcoding in a specified manner. Prohibits a provider from using an automated process, system, or tool to submit a health benefits claim without the review of a provider or other person involved in the development of the claim for submission. Prohibits an insurer that issues a policy of accident and sickness insurance (insurer) and a health maintenance organization from retroactively reducing the reimbursement rate for any CPT code. Sets forth limitations on the time frame in which an insurer and a health maintenance organization: (1) may request repayment of an overpayment, adjust a subsequent claim, recoup a paid claim, or retroactively audit a paid claim; and (2) is required to correct a payment error to a provider. Provides that if an insurer or a health maintenance organization recoups payment from a provider due to an error in coordination of benefits, the provider may submit a claim for the same services to the appropriate insurer or health maintenance organization.

Subjects

AGENCIES; Department of Insurance (IDOI)FINANCIAL SERVICES; Collection AgenciesHEALTH CARE FACILITIES; HospitalsHEALTH; Billing and CostsINSURANCE; GenerallyINSURANCE; Health InsuranceINSURANCE; Health Maintenance Organizations (HMOs)TRADE REGULATIONS; Consumer Credit and Consumer Protection (Including the Uniform Consumer Credit Code (UCCC))

Co-sponsors (7)

Lori Goss-Reaves · coauthor
Martin Carbaugh · coauthor
Victoria Garcia Wilburn · coauthor
Liz Brown · sponsor
Michael Crider · sponsor
Tyler Johnson · sponsor
Lonnie Randolph · cosponsor

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