RI H8267

Health insurers must reimburse healthcare providers at least 65% of unpaid co-payments, co-insurance, and deductible amounts after providers demonstrate reasonable collection efforts

Claims must be at least $250 and remain unpaid for more than 120 days without an active payment plan before providers can seek reimbursement

Healthcare providers must submit aggregate reimbursement requests by May 1 each year for the prior calendar year, with documentation of collection attempts including dates and methods of contact

Health insurers have 120 days to audit claims, notify providers of disputes, and pay undisputed amounts; disputed claims go through existing dispute resolution processes

Health Insurance Commissioner must promulgate regulations by January 1, 2027, consistent with CMS standards for reasonable collection efforts, and publish annual reports on reimbursed and denied claims