Prohibits assessment of a fee relating to the health insurance claims adjudication verification process on any healthcare provider or facility
Impact
The implications of HB 824 on state laws are significant as it creates a legal framework that prohibits health insurance issuers from imposing additional charges that could otherwise affect the operational viability of healthcare facilities. This law could potentially lead to lower healthcare costs as providers pass on savings to patients and focus on more essential healthcare operations. Furthermore, it sets a precedent in healthcare legislation that prioritizes the financial stability of care providers, thereby aiming to improve access to healthcare services for patients across the state.
Summary
House Bill 824 seeks to protect healthcare professionals and facilities from being charged fees associated with the adjudication of health insurance claims. The bill explicitly prohibits health insurance issuers and pharmacy benefit managers from directly or indirectly levying fees on these entities for components related to the claim adjudication process. This includes the adjudication of claims, processing or transmission of claims, and management of adjudication networks. By doing so, the legislation aims to reduce the financial burden on healthcare providers, ensuring that they can focus on delivering care rather than dealing with administrative costs.
Sentiment
Overall, the sentiment surrounding HB 824 appears to be positive among healthcare professionals and advocates for healthcare affordability. Supporters see this as a necessary measure to streamline the healthcare claim process and safeguard providers against excessive fees that could impede their ability to deliver care. However, there may be concerns from insurance companies regarding how this limitation could impact their administrative operations and financial viability. The discussion is generally centered around the balance of costs in healthcare versus maintaining just compensation for providers.
Contention
The primary contention surrounding HB 824 revolves around the impact of regulatory controls on the insurance marketplace and the potential for unintended consequences. While advocates argue that the bill will protect healthcare providers, opponents may raise concerns regarding the implications for insurance company operations, which might lead to higher premiums for consumers. The crux of the debate centers on whether protecting providers' revenues will compromise insurers' ability to deliver affordable coverage, thus raising questions about the balance between provider compensation and consumer costs.
Provides relative to utilization review standards and approval procedures for healthcare service claims submitted by healthcare providers (EN NO IMPACT See Note)
To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.
To Amend The Prior Authorization Transparency Act; And To Exempt Certain Healthcare Providers That Provide Certain Healthcare Services From Prior Authorization Requirements.
To Prohibit Healthcare Insurers From Exercising Recoupment For Payment Of Healthcare Services More Than One Year After The Payment For Healthcare Services Was Made.