A bill for an act relating to the recovery of overpayment of a claim by a dental carrier.(See HF 637.)
Impact
If enacted, HSB190 affects the relationship between dental carriers and providers by introducing stricter guidelines on how overpayments can be handled. It requires that a dental provider must receive written notice of an overpayment within 365 days of the payment date, ensuring that carriers cannot retroactively reclaim funds without due process. This legislation is intended to foster fairness and transparency in the recovery process, ultimately benefiting dental care providers who may previously have faced arbitrary reclaim requests from insurance carriers.
Summary
House Study Bill 190 (HSB190) addresses the issue of overpayment recovery by dental carriers. The bill mandates dental carriers to establish written policies and procedures that allow dental care providers to appeal any overpayment recovery requests. Crucially, the bill defines an 'overpayment' as any erroneous payment made to a dental provider for dental services. The bill sets forth a structured framework for both carriers and providers, ensuring that providers are informed of the policies within a specified timeframe and have the opportunity to contest recoveries effectively.
Contention
The bill has the potential to stir some contention among industry stakeholders. While proponents argue that it provides essential protections for dental care providers against unjust overpayment recoveries, critics may raise concerns about the ability of insurance carriers to manage their financial risk if they are limited in their ability to reclaim funds. Additionally, there may be apprehension regarding the enforcement of the bill and how it aligns with existing contracts between dental providers and carriers, as any conflicting contractual provisions would be rendered null and void under this law.
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See HF 525, HF 685.)
A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly HSB 177; See HF 685.)
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 the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See SF 462, SF 567.)