The bill amends the Healthcare Contracting Simplification Act by introducing a definition for "downcode," which refers to the practice of changing a claim to a lower-cost healthcare service than what was originally submitted by a healthcare provider. This new definition is added to the existing definitions in Arkansas Code 23-99-1202.

Additionally, the bill establishes a requirement for contracting entities that downcode claims to notify the healthcare provider of the downcoding within thirty days of processing the claim. This new notification requirement is outlined in a newly added section, 23-99-1211, ensuring that healthcare providers are informed about any changes made to their claims in a timely manner.

Statutes affected:
Old version HB1287 V2 - 2-10-2025 10:11 AM: 23-99-1202
Old version HB1287 Original - 1-28-2025 05:02 PM: 23-99-1202
HB 1287: 23-99-1202
Act 136: 23-99-1202