Bill > SB6071

This bill modernizes requirements for health insurance carriers to recover overpayments made to healthcare providers by adjusting the timeframes within which such recoveries can be requested. Specifically, for most overpayment claims, carriers will now have 12 months from the original payment date to request a refund, reduced from the previous 24 months, and for mental health and substance use disorder services, this period is shortened to six months from the original payment date. In cases involving coordination of benefits with another payer, the time limit for requesting a refund is extended to 18 months from the original payment date, or nine months for mental health and substance use disorder services, with contested refunds still needing to be paid no sooner than six months after the request. The bill also clarifies that a "refund" can include offsets to future payments and that these new time limits will supersede any conflicting contract terms between carriers and providers, while explicitly excluding dental-only carriers, Medicare, and Medicare supplemental plans from these provisions.

Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=6071&Year=2025&Initiative=false