Senate Bill No. 465, introduced by Senator McMath, seeks to amend the payment processes for healthcare providers in Louisiana by establishing stricter timelines for processing claims. The bill mandates that nonelectronic claims submitted within the insurer's timeframe be processed within 30 calendar days, while those requiring prior authorization must be processed within 10 calendar days. For electronic claims, prior authorized claims are to be paid within 10 days, and non-preauthorized claims must be processed within 25 days. Additionally, health insurance issuers are required to notify providers of any pended claims within two business days. The bill also repeals the previous provision allowing a 30-day payment standard with prior notice to the commissioner.

Furthermore, the legislation introduces a prohibition on retroactive denial or recoupment of claims for services rendered in good faith after 12 months from the initial payment date, extending this protection to dental insurance contractors. It also modifies the payment timelines for nonelectronic claims submitted by pharmacies, reducing the processing time from 45 days to 21 days for claims submitted within 45 days, and from 60 days to 30 days for claims submitted after 45 days. The bill applies these payment requirements to the office of group benefits, which was previously exempt, and prohibits any waivers of these provisions by contract. The proposed law is set to take effect on August 1, 2026.

Statutes affected:
SB465 Original: 22:1832(A), 22:1833(B), 22:1838(F), 22:1853(A), 22:1853(B)(1), 22:1853(C), 22:1854(A), 22:1854(B), 22:1854(C)
SB465 Engrossed: 22:1832(A), 22:1833(B), 22:1838(F), 22:1853(A), 22:1853(B)(1), 22:1853(C), 22:1854(A), 22:1854(B), 22:1854(C)
SB465 Reengrossed: 22:1832(A), 22:1833(B), 22:1838(F), 22:1853(A), 22:1853(B)(1), 22:1853(C), 22:1854(A), 22:1854(B), 22:1854(C)
SB465 Re-Reengrossed: 22:1155(C), 22:1832(A), 22:1833(B), 22:1838(F), 22:1853(A), 22:1853(B)(1), 22:1853(C), 22:1854(A), 22:1854(B), 22:1854(C)