summary
Introduced
01/06/2026
01/06/2026
In Committee
02/17/2026
02/17/2026
Crossed Over
01/28/2026
01/28/2026
Passed
02/24/2026
02/24/2026
Dead
Introduced Session
2026 Regular Session
Bill Summary
Nonparticipating providers. Requires an initiating party that submits a request for independent dispute resolution to provide written notice to the facility not later than three business days after submitting the request. Allows a health carrier to provide notice to an out of network provider and a facility if, during any 90 day period, an initiating party submits requests for independent dispute resolutions that, in the aggregate, include 25 or more qualified disputes. Provides that if a health carrier provides the notice, the health carrier, the out of network provider, and the facility shall engage in good faith efforts to negotiate a resolution. Prohibits a health carrier from assessing a facility or a provider an administrative fee or penalty related to the provision of care to an individual that involves an out of network provider. Provides that if a health carrier assesses a facility or a provider an administrative fee or penalty related to the provision of care to an individual that involves an out of network provider, the health carrier commits an unfair and deceptive act or practice in the business of insurance.
AI Summary
This bill establishes new rules for the independent dispute resolution process, which is a federal process used to resolve payment disputes between health carriers (insurance companies) and out-of-network providers (doctors or facilities not contracted with the insurer) for certain healthcare services. Key provisions include requiring the party initiating a dispute resolution request to notify the healthcare facility within three business days of submitting the request. If a health carrier receives 25 or more dispute resolution requests within a 90-day period, they can notify the out-of-network provider and facility, triggering a requirement for all parties to negotiate in good faith to resolve the issues. Furthermore, the bill prohibits health carriers from charging facilities or providers administrative fees or penalties related to care provided by out-of-network providers, and doing so would be considered an unfair and deceptive insurance practice.
Committee Categories
Business and Industry
Sponsors (10)
Scott Baldwin (R)*,
Chris Garten (R)*,
Tyler Johnson (R)*,
Brad Barrett (R),
Liz Brown (R),
Chris Campbell (D),
Martin Carbaugh (R),
Eric Koch (R),
Lonnie Randolph (D),
Craig Snow (R),
Last Action
Motion to concur filed (on 02/25/2026)
Official Document
bill text
bill summary
Loading...
bill summary
Loading...
bill summary
Loading...