Insurance Claims Payments to Health Care Providers

Summary

The bill would stop health insurers and other payment adjudicators from lowering the service codes on provider bills unless their contract explicitly allows it. It requires insurers to give providers detailed notice of any downcoding, the reasons, the payment they would have received, and a 15‑day window to contest the change. The measure also tightens prior‑authorization rules and claim‑payment timelines.

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

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