AN ACT REQUIRING HEALTH CARRIERS TO PAY A CIVIL PENALTY FOR ADVERSE DETERMINATION REVERSALS.

SB 1210 requires health insurance companies (health carriers) to pay a civil penalty when an independent review organization overturns a denied health insurance claim. The penalty, paid to the Insurance Fund, would fund the Office of the Healthcare Advocate. This directly affects health carriers who face reversed claim denials through external review. The bill creates a financial consequence for insurers whose initial denial decisions are invalidated by independent review.