The proposed bill amends various sections of the General Laws to enhance patient rights and improve the efficiency of claims processing in the healthcare sector. Key insertions include new definitions of "unprofessional conduct" for medical professionals, which encompass behaviors such as fraudulent licensing and patient abandonment. The bill specifically prohibits physicians from refusing to submit medical bills related to motor vehicle accidents or third-party claims and mandates that medical records or bills be processed within fourteen days of a written request. Additionally, healthcare facilities are required to provide patients with an itemized bill within fourteen days, down from the previous thirty days, and must inform patients of their rights regarding participation in human-subjects research.

The bill also establishes stricter requirements for healthcare entities and health plans regarding the processing of claims. It mandates that all complete claims for covered services be paid within specified timeframes—forty days for written claims and thirty days for electronic claims—and prohibits denial of claims based solely on their association with motor vehicle accidents or third-party claims. Healthcare entities must notify providers or policyholders within thirty days if a claim is denied or pending, detailing the reasons for denial. Furthermore, interest will accrue on unpaid claims after the specified timeframes, ensuring timely compensation for healthcare providers. Overall, the bill aims to create clearer standards for medical professionals and enhance protections for patients in their interactions with healthcare providers.

Statutes affected:
5066: 5-37-5.1, 23-17-19.1, 27-18-61, 27-19-52, 27-20-47, 27-41-64