HI HB796

Requires insurance entities to send written notice to health care providers at least 30 calendar days before initiating recoupment or offset demand efforts.

Notice must prominently display the patient's name, date services were provided, payment amount received, reason for recoupment/offset, and appeal contact information with a 60-day appeal deadline.

Prohibits entities from initiating recoupment or offset more than 12 months after initial claim payment, except for cases involving reasonable belief of intentional fraud, material misrepresentation, or Medicaid/Medigap claims.

Allows entities to continue resolving claims involving coordination of benefits, subrogation, preexisting condition investigations, or third-party liability without the 12-month time restriction.

Effective date July 1, 2050.