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2023 SESSION

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HB 1739 Health carrier fair business standards; SCC's Bureau of Insurance to evaluate.

Introduced by: Christopher T. Head | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED HOUSE:

State Corporation Commission; work group; health carrier fair business standards. Directs the State Corporation Commission's Bureau of Insurance to convene a work group to develop recommendations for regulatory and legislative changes necessary to improve the process for determining if an insurance carrier has failed to implement minimum fair business standards in the performance of its provider contracts for the prompt payment of claims. The Bureau shall submit a report of the findings and recommendations of the work group by December 1, 2023. This bill is identical to SB 927.

SUMMARY AS INTRODUCED:

Ethics and fairness in carrier business practices; failure to comply. Provides that any provider or person that submits a complaint to the State Corporation Commission alleging a violation of carrier or provider business practices may request a determination from the Commission of whether a carrier has failed to implement minimum fair business standards as required by the Code. Under the bill, the Commission may require a carrier to make an interim payment to a complainant for the claims in controversy. If the Commission determines that a carrier has failed to comply with the minimum fair business standards, the carrier must submit a plan of corrective action to the Commission and complainant within 30 days of the Commission's decision. The bill also permits any provider for which the Commission determines that a carrier has failed to implement minimum fair business standards to file an action to recover actual damages and obtain other injunctive relief.