Senate Bill No. 341 proposes amendments to the laws governing the return of health care provider payments by contracting health organizations. The bill reduces the time frame in which these organizations can cancel, deny, or demand the return of payment for authorized covered services due to administrative or eligibility errors from 18 months to 12 months after receiving a clean claim. Additionally, it specifies that organizations must provide at least 30 days' advance notice of such actions, which must be sent via certified mail with return receipt requested or to a designated email address. The bill also introduces a requirement for organizations to notify providers of their appeal determinations within 15 business days; if they fail to do so, the appeal will be construed in favor of the provider.

The bill includes several provisions that maintain the existing exceptions to the time limit for payment cancellations, denials, or demands, such as cases of suspected fraud or improper billing. Furthermore, it allows providers one year to identify other applicable insurance coverage and file claims, regardless of the timely filing requirements of the other insurers. The effective date for these changes is set for January 1, 2027. Overall, the bill aims to streamline the process for health care providers and ensure they have adequate notice and opportunity to appeal payment disputes.