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CA AB399

Bill

Status

Engrossed

1/27/2022

Primary Sponsor

Rudy Salas

Click for details

Origin

State Assembly

2021-2022 Session

AI Summary

  • Limits the independent bill review eligibility fee to $50 to determine if a request is reviewable, with additional fees allowed for reviewable requests determined by the administrative director.

  • Requires independent bill review organizations to bill employers for additional review fees when they find additional payment is owed to the medical provider, and reimburse the provider's eligibility fee within five business days.

  • Requires independent bill review organizations to bill medical providers for additional review fees when no additional payment is found owing, with 10% penalty plus interest if not paid within 10 days.

  • Requires employers to pay any additional amounts found owing by independent bill reviewers within 30 days of the final determination.

  • Establishes dispute resolution procedures for claims administrators and providers regarding independent bill review fees, to be submitted to the administrative director for informal resolution.

Legislative Description

The Medical Provider Network Transparency Act of 2022.

Last Action

In committee: Set, first hearing. Hearing canceled at the request of author.

5/24/2022

Committee Referrals

Labor, Public Employment and Retirement5/4/2022
Rules1/27/2022
Appropriations1/11/2022
Insurance2/12/2021

Full Bill Text

No bill text available