HB 1446 Summary

• Reduces the time limit for health insurers to initiate recoupment or offset demands from health care providers from 18 months to 12 months after initial claim payment.

• Requires health insurers to provide written notice at least 30 calendar days before initiating recoupment efforts, including patient name, service date, payment amount, reason for recoupment, and appeal procedures.

• Establishes a 60-day appeal deadline for health care providers to contest recoupment demands, with non-appealed demands deemed accepted.

• Extends the 24-month deadline for recoupment efforts involving coordination of benefits, subrogation, preexisting condition investigations, or third-party liability, with a minimum 6-month waiting period before requesting payment.

• Allows recoupment at any time when a third party is found liable and the insurer cannot recover directly from that third party because it will pay the health care provider.