HF2927 Summary

• Establishes definition of "health care clearinghouse" as a public or private entity that processes health information between providers, group purchasers, and payers, including billing services and community health management information systems.

• Requires group purchasers and health care providers to accept and transmit electronic eligibility, claims, and payment transactions according to federal standards beginning January 15, 2009, with specific deadlines for each transaction type through December 15, 2009.

• Mandates electronic acknowledgments for claims and payment transactions starting January 1, 2012, using specified American National Standards Institute standards (TA1, 997, 999, or 277CA).

• Prohibits health care providers, clearinghouses, and group purchasers from charging fees to each other for standard transactions, and allows direct data entry and Web-based methods for transaction compliance.

• Authorizes the Commissioner of Health to investigate compliance complaints, impose civil penalties up to $100 per violation (not exceeding $25,000 annually), and provides protection against retaliation for complaint filing or cooperation with investigations.