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Assembly hears AB282 to require timely refunds when patients are overcharged by health providers
Summary
Assemblymember David Orentlicker told the Assembly Health and Human Services Committee that AB282 would require health-care providers to investigate suspected billing errors within 30 days and to refund confirmed overpayments within 30 days after a final payment determination.
Assemblymember David Orentlicker presented Assembly Bill 282 to the Assembly Committee on Health and Human Services, saying the bill is intended to ensure patients receive timely refunds when they have been overcharged by doctors, hospitals or other health-care providers.
Orentlicker said the bill applies broadly and is modeled on steps taken in other states. Under the version presented, when a facility or practitioner is notified of a possible overcharge they must investigate within 30 days and, if an overpayment is confirmed once an insurer’s Explanation of Benefits (EOB) is finalized, refund the patient within 30 days of that determination. The bill also would prohibit providers from issuing new bills for the disputed charge while the investigation is pending and would require written communications to patients about the status of their complaint.
Former Assemblymember Ellen Spiegel described her personal experience seeking refunds after substantial medical bills in 2023. Spiegel said she paid a $1,457.75 deposit for treatment scheduled for April 5; the first EOB processed May 9 listed a patient cost share of $255.36, creating what Spiegel described as an initial overpayment of $1,202.39. Spiegel told the committee a later final EOB dated July 18 changed the patient cost share to $181.06 and that the provider ultimately owed her $12,076.69; she said she did not receive a refund until Nov. 16. Spiegel told the committee that, under AB282’s timelines, she would have received a refund no later than Aug. 17 and that the proposed law would have saved finance charges she incurred while waiting for repayment.
Patient advocates and individuals testified in support. Vivian Leal, a long-time patient advocate, told the committee that complex billing rules, changing in-network designations and overlapping deadlines create repeated errors and denials that patients — especially those who are ill or lack resources — find difficult to resolve. Jane Grossman, who said her 2023 medical bills totaled $195,136 with a $7,000 out-of-pocket maximum, said she had to spend months and numerous contacts to recover roughly $1,000.
Industry representatives expressed technical concerns. Nick Schneider of the Las Vegas Chamber said the bill’s hard deadlines and the absence of a statute of limitations for patient notices could create practical problems because providers are required to keep records for specified retention periods, and reviewing very old claims may be difficult. Representatives of the Nevada Hospital Association and Nevada Rural Hospital Partners said they need more time to work with the sponsor to resolve technical language and to ensure the bill does not inadvertently create burdens that would discourage providers from practicing in Nevada.
Orentlicker told the committee he would work with stakeholders on drafting details, including the appropriate timing and the scope of sanctions. No vote was taken at the hearing; the sponsor asked to take stakeholder input and bring proposed amendments back to the committee.
