Requires insurers to pay electronic claims for healthcare coverage within 14 calendar days of receipt. Permits healthcare providers to dispute claim denials within 60 days and empowers the secretary of EOHHS to establish penalties for violations.

Plain-English Summary

This bill would set new rules for how quickly health insurance companies must pay doctors, hospitals, and other healthcare providers after receiving a claim electronically. Under the proposal, insurers would be required to pay electronic healthcare claims within 14 calendar days of receiving them — much faster than current timelines. This applies to claims submitted digitally, which is the most common method used by healthcare providers today.

The bill also gives healthcare providers a way to push back if a claim is denied. Providers would have 60 days to formally dispute a denial, giving them a reasonable window to gather information and challenge decisions they believe are incorrect. Additionally, the bill would give the Secretary of the Executive Office of Health and Human Services (EOHHS) the authority to create and enforce financial penalties against insurance companies that don't follow these rules, adding teeth to the requirements.

This legislation primarily affects health insurance companies and the healthcare providers — such as doctors' offices, clinics, and hospitals — who submit claims to those insurers. Faster payments could help healthcare providers manage their finances more predictably and reduce administrative burdens. Patients could indirectly benefit if providers spend less time and resources chasing delayed payments. The bill is currently being held for further study by the House Health & Human Services Committee, meaning it has not yet moved forward in the legislative process.