The bill amends section 3901.388 of the Revised Code to modify the timeframe for health insurers to recoup payments from healthcare providers. Specifically, it reduces the period during which a payment is considered final from two years to one year after the payment is made. Additionally, it stipulates that a third-party payer must initiate the recovery of any overpayment within one year of the payment date, and it requires that providers be given an opportunity to appeal the determination of overpayment without incurring any fees.

Furthermore, the bill updates the notice requirements for overpayment determinations, specifying that the notice must include detailed information such as the beneficiary's name, service dates, overpayment amount, and the basis for the overpayment determination. It also extends the response time for providers from thirty days to sixty days. The bill clarifies that any contractual provisions contrary to these new regulations will be unenforceable, ensuring that the updated rules are upheld in all relevant agreements.

Statutes affected:
As Introduced: 3901.388
As Reported By Senate Committee: 3901.388
As Passed By Senate: 3901.388
As Reported By House Committee: 3901.388
As Passed By House: 3901.388
As Enrolled: 3901.388