Health insurance; carrier business practices, method of payment for claims.
What changed between versions
Updated the deadline for carriers to notify providers about payment defects and the requirement to provide additional information for processing claims.
Added new requirements for carriers to clearly disclose bundling and downcoding policies in provider contracts or on their websites, and to provide these policies within 10 business days of a request.
Added a requirement for carriers to provide copies of or electronic access to all applicable policies within 10 business days of a request.
Added a new provision requiring carriers to pay claims that have been previously authorized as medically necessary and covered, unless specific exceptions apply.
Changed the effective date for mandatory electronic delivery of notifications and information from January 1, 2026, to a later date (specific year not fully visible in snippet but implies a shift or correction).
Corrected a typo in the section regarding retroactive denials, changing 'subdivision 7 8' to 'subdivision 7'.