This bill amends the existing workers' compensation law to establish a 90-day time limit for health care providers to apply to the commissioner for resolution of disputes regarding the reasonable value of services provided. Specifically, it requires that providers notify the employer or their insurance carrier of any disagreement regarding payment within 45 days of receiving payment. Furthermore, the application to the commissioner can only be made if no more than 45 days have passed since this notification. The bill emphasizes the need for efforts to resolve disputes prior to seeking commissioner intervention.

Additionally, the bill clarifies that the commissioner will have exclusive jurisdiction to determine the reasonable value of services in cases where disputes arise between employers or their insurance carriers and service providers. It stipulates that all interested parties are entitled to notice and a hearing if it is determined that reasonable efforts to resolve the dispute have failed. The act will take effect 60 days after its passage and is projected to have a minimal fiscal impact of less than $10,000 in each fiscal year from 2025 to 2028.

Statutes affected:
Introduced: 281-A:24