limit the ability of a health carrier to recoup, recover, or retroactively deny previously paid claims.

Summary

The bill restricts health carriers to a maximum of eighteen months after a claim is paid to recover or deny that payment, provided they give written notice to the provider. It sets out exceptions (fraud, other payors, certain insurance types, federal programs, workers' compensation, duplicate payments) and creates a notice‑and‑response process with the Division of Insurance handling disputes. The measure aims to protect providers from indefinite claim reversals while still allowing legitimate corrections.

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

Topics

Share