The bill amends the Healthcare Contracting Simplification Act by introducing a definition for "downcode," which is described as the act 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 mandates that contracting entities must notify healthcare providers if a claim has been downcoded. This notification must occur within thirty days of processing the claim, ensuring that providers are informed of any changes made to their submitted claims. These amendments aim to enhance transparency and communication between healthcare providers and contracting entities regarding claim processing.

Statutes affected:
HB 1287: 23-99-1202