Rhode Island Senate Bill S0846

Rhode Island 2025 Regular Session

• Introduced: 3/19/25
• Refer: 3/19/25

Caption

Prohibits healthcare providers and health plans from denying the payment of a medical bill, solely because the bill may have arisen from a third-party claim.

Impact

Should S0846 be enacted, it is likely to have significant implications on state laws regarding healthcare practices and insurance claims processing. The bill requires that healthcare entities inform providers and policyholders of any denial or pending status of claims within thirty days, while mandating that they pay interest on late reimbursements. This emphasis on timely communication and payment could reform the current landscape of healthcare financing, compelling insurance companies to adhere to stricter deadlines and protocol. As a result, healthcare providers may experience improved cash flow, thereby enabling them to devote more resources to patient care.

Summary

S0846 is a legislative proposal aimed at reforming the healthcare claim payment process. The main provision of this bill prohibits healthcare entities and health plans from denying a claim based solely on the reason that the medical bill may have arisen from a third-party claim or incident, with the notable exception being workers' compensation claims. This measure seeks to protect healthcare providers and policyholders from unjust denials that may compromise their financial stability and access to necessary medical care. By ensuring that medical bills originating from third-party incidents are honored, the bill aims to streamline processes and increase accountability within healthcare billing practices.

Contention

The passage of S0846 may face opposition from insurance companies and entities that contend it could lead to increased costs due to mandatory payments on claims they would otherwise dispute. Critics may argue this legislation could restrict their ability to challenge claims that they believe are unjustified or fraudulent. Moreover, concerns may arise regarding the definitions of 'third-party claims' and the potential for abuse of the system by claimants seeking undeserved reimbursement. Consequently, careful monitoring and regulation would be needed to balance the interests of both providers and insurers while ensuring consumer rights are upheld.