Arkansas 2025 Regular Session

Arkansas House Bill HB1299

Introduced
1/29/25  

Caption

To Prohibit Healthcare Insurers From Exercising Recoupment For Payment Of Healthcare Services More Than One Year After The Payment For Healthcare Services Was Made.

Impact

If enacted, HB1299 would amend Arkansas Code Title 23, Chapter 99, introducing a new subchapter that outlines the parameters for recoupment practices. The bill specifies that recoupment can only occur within 365 days unless a case of fraud against the system is established. By limiting the timeframe for insurers to request refunds, the bill aims to foster a more equitable landscape for healthcare providers, encouraging them to deliver services without the fear of financial repercussions stemming from past claims. This change could have far-reaching implications for the operational practices of both insurers and providers.

Summary

House Bill 1299 proposes a significant change to how healthcare insurers can handle recoupment, or the recovery of payments made for healthcare services. Specifically, the bill prohibits healthcare insurers from exercising recoupment for healthcare services payment more than one year after the payment was made. This provision is designed to provide financial stability for healthcare providers, ensuring that payments made in good faith cannot be retroactively disputed after an extended period. The emphasis is on protecting healthcare providers from undue financial pressure while maintaining necessary insurer oversight.

Contention

While the bill has garnered support from healthcare providers, it may face opposition from insurance companies who argue that loosening recoupment regulations can lead to increases in fraudulent claims or abused systems. The initial provisions set forth in the bill mean that insurers will have less leverage in recovering overpayments based on changing regulations or determinations about the necessity of healthcare services over time. This could result in debates over the balance between protecting healthcare providers and ensuring that insurers can effectively manage their risk and losses.

Notable_points

Key to this bill is the provision that if healthcare services were authorized beforehand, insurers cannot later invalidate the payment based on retrospective decisions about necessity or service levels unless fraud is involved. This protection guarantees that healthcare providers are not penalized for decisions made in accordance with authorization received from insurers. Such stipulations may redefine how contracts are structured between insurers and healthcare providers, placing more emphasis on pre-approval processes and compliance requirements.

Companion Bills

No companion bills found.

Previously Filed As

AR HB1272

To Amend The Healthcare Contracting Simplification Act; And To Prohibit A Healthcare Insurer From Leasing A Healthcare Contract Or Provider Network.

AR HB1271

To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.

AR SB143

To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.

AR SB119

To Clarify Payment For Healthcare Services Performed By Certain Outpatient Surgery Centers.

AR HB1275

To Regulate Electronic Medical Records; And To Prohibit A Healthcare Payor That Has Electronic Access To Medical Records From Requesting Medical Records In A Different Format From A Healthcare Provider.

AR SB187

To Repeal The Healthcare Quality And Payment Policy Advisory Committee Act.

AR SB141

To Amend The Prior Authorization Transparency Act; And To Clarify That A Healthcare Insurer From Out Of State Is Subject To The Prior Authorization Transparency Act If That Healthcare Insurer Has Subscribers In This State.

AR SB142

To Amend The Healthcare Contracting Simplification Act; And To Regulate Network Leasing Under The Healthcare Contracting Simplification Act.

AR HB1741

To Require Consent To The Assignment Of Benefits To A Healthcare Provider; And To Mandate Notice To An Enrollee Of The Assignment Of Benefits To A Healthcare Provider.

AR SB112

To Authorize Physician Assistants To Be Identified As A Treating Provider For Insurance Billing And Claims And To Bill And Receive Payment For Provided Healthcare Services.

Similar Bills

AR SB143

To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.

AR HB1271

To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.

AR HB1301

To Amend The Prior Authorization Transparency Act.

CA AB781

Medi-Cal: family respite care.

SC H4562

Healthcare Services

CA AB918

Health care district: County of Imperial.

MS HB934

Healthcare Contracting Simplification Act; create.

KY HB200

AN ACT relating to the healthcare workforce, making an appropriation therefor, and declaring an emergency.