This bill amends the managed care law to further the notice requirements for denial or pending claims made by health carriers. Currently, health carriers have a certain amount of time to notify the health care provider or covered person of the reason for denying or pending a claim and what additional information is required. This bill adds that if the health carrier fails to provide the required notice or adjudicate the claim within 45 calendar days of receiving additional information, the claim shall be treated as a clean claim and adjudicated accordingly.

The effective date of this bill will be 60 days after its passage.

Statutes affected:
Introduced: 420-J:8-a