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PA HB966
Bill
Status
3/19/2025
Primary Sponsor
Arvind Venkat
Click for details
AI Summary
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Amends The Insurance Company Law of 1921 to require the Insurance Department to post its annual report on claim denials and appeals on its public website
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Imposes mandatory penalties on health insurers when more than 50% of their adverse benefit determinations (excluding administrative denials) are overturned through internal appeals or external review processes in a calendar year
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Establishes escalating penalties for each overturned denial exceeding the 50% threshold: $50,000 for the first, $100,000 for the second, and $250,000 for the third and each subsequent overturned determination
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Directs all collected penalty funds to be used by the Insurance Department for consumer protection activities
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Takes effect six months after enactment
Legislative Description
In quality health care accountability and protection, further providing for departmental powers and duties and providing for additional penalties.
Last Action
Referred to Insurance
3/19/2025