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OH SB162
Bill
Status
Introduced
4/1/2025
Primary Sponsor
Louis Blessing
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AI Summary
- Replaces the fixed two-year window for health insurers to recoup overpayments from providers with a variable timeframe equal to the number of days the insurer allows providers to file claims
- Payments become final and non-adjustable (except for fraud) once this matching timeframe expires, creating symmetry between provider claim-filing deadlines and insurer recoupment deadlines
- Prohibits third-party payers from changing payment, audit, or review timelines during the contract period
- Requires insurers to provide written notice of overpayment determinations and prohibits charging providers fees for appealing those determinations
- Contract provisions that conflict with these recoupment timeline requirements are unenforceable
Legislative Description
Regards timing of health insurer recoupment from providers
Health and Human Services : Medicaid
Last Action
Referred to committee: Financial Institutions, Insurance and Technology
4/2/2025
Committee Referrals
Financial Institutions, Insurance and Technology4/2/2025
Full Bill Text
No bill text available