SB 1441 Summary

• Establishes a new dispute resolution process for "surprise out-of-network" bills where enrollees can seek arbitration if the bill exceeds $1,000 after deducting cost-sharing and insurer payment.

• Requires health insurers to adjudicate clean claims within 30 days and pay approved claims within 30 days, with interest penalties calculated at the legal rate for late payments.

• Creates a mandatory informal settlement teleconference within 30 days of arbitration request, with arbitration to follow within 120 days if the dispute is unresolved.

• Designates the Department of Insurance to develop arbitration procedures, contract with arbitrators (with minimum 3 years health care claims experience), and prohibit department staff from serving as arbitrators.

• Requires annual reporting to the legislature on dispute resolution outcomes, including number of qualified requests, settlement rates, bill reduction percentages, and other performance metrics, beginning December 31, 2019.