RI S3088

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

Claims must be at least $250 and remain unpaid for more than 120 days from the first bill date, with documented collection efforts including phone calls, letters, or other contact methods

Healthcare providers must submit aggregate reimbursement requests annually by May 1 for claims from the prior calendar year, including insured identification, service dates, and collection documentation

Health insurers have 120 days to audit requests and pay undisputed amounts; any patient payments collected after insurer reimbursement must be reported as offsets to future submissions

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