SB 1023
Creates standards for predetermination of health care benefits requests and responses
LR Number:
Last Action:
2/23/2016 - Hearing Conducted S Small Business, Insurance and Industry Committee
Journal Page:
Calendar Position:
Effective Date:
July 1, 2017

Current Bill Summary

SB 1023 - This act requires health benefit plans that receive electronic health care predetermination requests from health care providers to provide the requesting health care provider information on the amounts of expected benefits coverage on the procedures specified in the request. The act also requires health care providers and health benefit plans to comply with defined administrative simplification procedures when submitting and replying to health care predetermination requests. This act requires a health benefit plan's response to be returned in the same manner as the request was received. This act also prohibits collection of any payment prior to or as a condition of receiving the health benefit services that are the subject of a health care predetermination request unless the practice is not prohibited by the provider agreement with the health benefit plan.

This act is effective July 1, 2017.

This act is substantially similar to HB 2477 (2016) and similar to provisions in HCS/HB 2269 (2016).