Health insurance companies can now only take back or deny payment for previously paid claims within 18 months of paying them, and only if they give the provider written notice of why—this protects providers from surprise claim denials years later. The rule has exceptions for claims involving fraud, waste, abuse, or claims involving other insurance types like Medicare, Medicaid, workers' compensation, or when a provider was already paid for the same service. The Division of Insurance will enforce this new requirement.
The amendment dramatically weakens the bill by gutting the dispute resolution process—it eliminates the 30-day advance notice requirement, the six-month refund period, the provider's ability to contest denials, and the mandatory Division of Insurance review process that previously protected providers. The revised version now allows health carriers to recoup claims within 18 months with minimal procedural protections, and it adds a carve-out excluding dental, pharmaceutical, and prescription drug services from coverage.
This change converted the bill from an engrossed draft to its final enrolled version for passage, adding formal legislative signatures and certification pages while preserving all substantive provisions that limit health carriers' ability to recoup previously paid claims to eighteen months with written notice.
Signed by the Governor H.J. 579
Delivered to the Governor H.J. 546
Signed by the President S.J. 506
Signed by the Speaker H.J. 529
Senate Do Pass Amended Passed, YEAS 34, NAYS 0. S.J. 461
Health and Human Services Certified uncontested, placed on consent S.J. 25
Health and Human Services Do Pass Passed, YEAS 7, NAYS 0. S.J. 25
Health and Human Services Scheduled for hearing
First read in Senate and referred to Senate Health and Human Services S.J. 357
House of Representatives Do Pass Amended Passed, YEAS 67, NAYS 0. H.J. 390
Commerce and Energy Do Pass Amended Passed, YEAS 12, NAYS 1.
Commerce and Energy Motion to amend
Commerce and Energy Scheduled for hearing
First read in House and referred to House Commerce and Energy H.J. 218
Prime sponsor · Rep.
R
Prime sponsor · Sen.
R
Do Pass Amended
Health and Human Services — Do Pass
Do Pass Amended
Commerce and Energy — Do Pass Amended