A bill for an act relating to secondary health benefit plans' access to explanation of benefits from primary health benefit plans.(See HF 467.)
Impact
The introduction of HF226 could significantly affect how health insurance claims and payments are processed. By establishing a time frame for the delivery of EOB documents, the bill intends to reduce delays that insured individuals face when navigating their health care benefits. If enacted, it may lead to improved efficiency within health care administrative processes, ultimately benefiting consumers by making it easier for them to understand their coverage and out-of-pocket costs.
Summary
House File 226 (HF226) is a legislative proposal aimed at enhancing access to explanations of benefits (EOB) by secondary health benefit plans from primary health benefit plans. The bill mandates that when a secondary health benefit plan requests an EOB from a covered individual's primary plan, the primary plan must provide this information within 20 calendar days. This initiative is designed to streamline the administrative interaction between different health insurance providers, ensuring that individuals have timely access to important health care information.
Contention
While HF226 aims to clarify communication between primary and secondary health plans, it may not be without contention. Some stakeholders in the health insurance sector may argue about the feasibility of complying with the 20-day requirement, raising concerns about the operational impacts that could arise from such mandates. Additionally, critics might contend that the bill does not address broader issues within the health insurance landscape that affect consumers, such as coverage limitations or the cost of services, resulting in a potential oversight of more comprehensive reforms.
Overall_effect
Ultimately, HF226 seeks to enhance consumer access to important health care information, potentially reshaping the relationships between different insurance providers. The effective implementation of this bill could lead to more informed patients who are better able to manage their health care choices. Continuous dialogue among legislators, health care providers, and insurance companies will be crucial to address any challenges that arise from the bill's provisions.
A bill for an act relating to continuity of care and nonmedical switching by health carriers, health benefit plans, and utilization review organizations, and including applicability provisions.(See HF 626.)
A bill for an act relating to continuity of care and nonmedical switching by health carriers, health benefit plans, and utilization review organizations, and including applicability provisions.
A bill for an act relating to continuity of care and nonmedical switching by health carriers, health benefit plans, and utilization review organizations, and including applicability provisions. (Formerly HF 96.) Effective date: 07/01/2024. Applicability date: 01/01/2025.
A bill for an act relating to pharmacy benefits manager reverse auctions and group insurance, and annual reporting by pharmacy benefits managers. (Formerly SF 284.)