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RI H7941
Bill
Status
2/27/2026
Primary Sponsor
Marie Hopkins
Click for details
AI Summary
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Reduces the deadline for health insurers to pay complete electronic claims from 30 calendar days to 14 calendar days; written claims remain at 40 days
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Shortens the timeframe for insurers to notify providers of claim denials or requests for additional information from 30 days to 14 days
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Healthcare providers and policyholders may seek review of denied claims within 60 days, with the payor bearing the burden of proving the denial was legitimate
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If a claim denial is overturned, the payor must remit the full amount owed plus an administrative penalty established by the EOHHS secretary to cover costs incurred by the provider
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Grants the EOHHS secretary authority to promulgate rules, regulations, and penalty schedules for enforcement; non-compliance constitutes a violation subject to EOHHS-determined penalties
Legislative Description
Requires insurers to pay electronic claims for healthcare coverage within 14 calendar days of receipt. Permits healthcare providers to dispute claim denials within 60 days and empowers the secretary of EOHHS to establish penalties for violations.
Insurance
Last Action
Introduced, referred to House Health & Human Services
2/27/2026