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Bill > SB0178


IN SB0178

IN SB0178
Payment of insurance claims.


summary

Introduced
01/05/2026
In Committee
01/05/2026
Crossed Over
Passed
Dead

Introduced Session

2026 Regular Session

Bill Summary

Payment of insurance claims. Provides that an insurer may not adjust a subsequent claim filed by a provider as a method of obtaining reimbursement of an overpayment made by the insurer on a prior claim by the provider. Provides that a health maintenance organization may not adjust a subsequent claim filed by a provider as a method of obtaining reimbursement of an overpayment made by the health maintenance organization on a prior claim by the provider. Provides that an insurer may not, more than one year after the date on which an overpayment on a provider claim was made to the provider by the insurer, request that the provider repay the overpayment (current law is two years). Provides that a health maintenance organization may not, more than one year after the date on which an overpayment on a provider claim was made to the provider by the health maintenance organization, request that the provider repay the overpayment (current law is two years). Makes conforming changes.

AI Summary

This bill, effective July 1, 2026, makes changes to how insurers and health maintenance organizations (HMOs) can recover overpayments made to healthcare providers. Specifically, it prohibits insurers and HMOs from adjusting a provider's future claim to recoup an overpayment from a past claim, and it shortens the time frame for insurers and HMOs to request repayment of an overpayment from two years to one year. This aims to provide more clarity and protection for providers in the claims payment process.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

First reading: referred to Committee on Insurance and Financial Institutions (on 01/05/2026)

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