HB 2290 Summary

• Establishes new definitions for health care plans and facilities, and adds "Health Care Plan" as a distinct term excluding limited benefit coverage.

• Requires health care insurers to provide claim denial contact information and detailed denial reasons within 15 days upon request, including information about appeal and grievance rights.

• Creates new hearing process allowing health care providers to request administrative hearings through the Department if internal grievance disputes remain unresolved within 30 days.

• Reduces credentialing timeline from 100 to 145 calendar days for applicants and requires written confirmation within 2 business days of receiving complete applications and within 7 business days for applications with deficiencies.

• Requires health insurers to pay claims for covered services provided by participating providers whose credentialing applications have been approved retroactively to the date of their complete application submission.