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Panel debates time limits for medical provider disputes in workers' compensation billing
Summary
Senate Bill 67 would set a deadline for medical providers to dispute workers' compensation bill payments; proponents said a limit would reduce years-long reopened claims, while providers and some hospitals urged a much longer window or alternatives such as mediation to avoid increasing hearings.
Senate Bill 67 would impose a deadline for medical providers to dispute payment amounts they receive from insurance carriers or self-insured groups for services rendered under workers' compensation. The bill, as introduced, set two 45-day windows (90 days total) after payment for provider notification and negotiation; testimony referenced an original 90-day draft and an amendment that would use 45 days per window.
Peter O'Neil, communications director to a senate sponsor, described the proposal as a narrow change intended to prevent medical providers from filing disputes years after a claim is closed. He told the committee: "All senate bill 67 does is introduce a reasonable time limit, which is outlined as 90 days in this bill." O'Neil said the limit would be three times the 30 days carriers currently have to pay bills.
Representatives of self-insured groups and third-party administrators said open-ended disputes can surface after policy years are closed and surplus returns have occurred, leaving trustees and members exposed. Peter Bragdon, representing the Lawson Group, which administers several New Hampshire self-insured trusts, said 90 days total (two 45-day periods) was reasonable and that self-insured groups would accept additional flexibility in complex cases if both parties agreed.
Medical providers and hospital representatives warned that the bill's original windows were too short for their billing and appeals processes. Jennifer White, CEO of Concord Orthopedics, said "claims don't actually pay in 30 days" and urged a substantially longer period; multiple provider witnesses asked for 12 to 18 months to consolidate episode billing and avoid a surge of hearings. Providers also said that payments are often not paid correctly, that appeals are administrative and time-consuming, and that a short statutory deadline would increase hearings and administrative burdens.
Deputy Commissioner Danielle Albert of the Department of Labor said the department was neutral and that it interprets the original drafting to require providers to issue notice within the first window and request a hearing in the second window; the department noted the drafting could make the available overall time shorter depending on when the initial notice is sent, and recommended clearer language if the committee's intent is to guarantee a full period for providers to resolve disputes.
Committee action: After testimony and an extended discussion about amendment language and options, the committee voted at executive session to recommend Senate Bill 67 "Inexpedient to Legislate" (ITL), 18-0.
What changed in committee: Witnesses reported an ongoing negotiation over exact time frames (45 days, 90 days, or longer) and suggested alternatives including mediation, clearer definitions when the clock starts, and a post-negotiation optional extension if both parties agree.
