Rhode Island House Bill H5066

Rhode Island 2025 Regular Session

• Introduced: 1/16/25
• Refer: 1/16/25

Caption

Prohibits certain claim practices of health insurers and medical providers. The act would further require fulfillment of medical record requests within fourteen (14) days.

Impact

If enacted, this legislation would amend existing laws governing the prompt payment of healthcare claims, establishing clear timelines within which insurance companies and providers must operate. Healthcare entities are required to process completed claims within specified timeframes—40 calendar days for written claims and 30 calendar days for electronic submissions. The bill also introduces penalties for delays, including interest payments on claims that are not processed within the prescribed periods, thereby encouraging compliance among healthcare entities.

Summary

House Bill H5066 aims to enhance the processing of insurance claims by health insurers and medical providers, specifically addressing claims arising from motor vehicle accidents and ensuring timely fulfillments of medical record requests. The bill prohibits health insurers from denying claims solely based on the circumstances of a motor vehicle accident and mandates that healthcare providers submit claims to health insurers without issue. Additionally, it requires that endorsements made to first-party insurance policies cannot occur without the express written consent of the policyholder, thus protecting consumers against unauthorized charges.

Contention

While the bill has garnered support for its consumer protection aspects, concerns have been raised regarding the potential strain this legislation could place on healthcare providers and insurance companies. Opponents argue that the bill may complicate the already intricate landscape of claims processing, creating logistical challenges while potentially increasing administrative costs. Those in favor contend that the proactive measures are essential to safeguard patient rights and enhance transparency in healthcare billing processes.