Insurance Claims Payments to Health Care Providers

Summary

The bill creates new rules that stop insurers and other payment adjudicators from changing a provider’s service codes to lower‑paying ones unless the provider’s contract explicitly allows it. It forces insurers to give clear notice, explain the change, let providers contest within 15 days, and keep transparent downcoding policies online. The measure aims to protect doctors and facilities from reduced payments and to improve claim‑payment transparency.

AI-generated summary — may be incomplete or inaccurate. Verify against the official bill text.

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