The bill introduces a new chapter, Chapter 18.10, titled "Equitable Funding for Healthcare Provider Bad Debt," to Title 27 of the General Laws concerning insurance. It establishes definitions for key terms such as co-insurance, co-payment, and deductible. The bill mandates that health insurers reimburse healthcare providers no less than sixty-five percent (65%) of each unpaid co-payment, co-insurance, or deductible amount due under an insured's health benefit plan after reasonable collection efforts have been made by the healthcare provider.

The bill outlines specific conditions under which healthcare providers can submit requests for reimbursement, including that claims must be for amounts of at least $250, and that the healthcare provider must have made reasonable collection efforts, which include documentation of attempts to collect the debt. The healthcare provider is required to submit an aggregate request for reimbursement by May 1 of each year, including detailed documentation of the claims.

Additionally, the bill stipulates that health insurers cannot prohibit healthcare providers from collecting co-payments, co-insurance, or deductible amounts at the time of service. It requires the health insurance commissioner to promulgate regulations by January 1, 2027, that align with federal guidelines on reasonable collection efforts. If the commissioner fails to do so, the provisions of the chapter will be self-implementing. Furthermore, health insurers must provide an annual report to the health insurance commissioner detailing the total number and amount of uncollected co-payments, co-insurances, and deductibles that are reimbursed as well as those that are denied, with this information made publicly available. The act will take effect upon passage.