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House debate stalls on insurance claim timeframes; substitute bill circled after hours of floor amendments
Summary
Lawmakers spent hours debating pink‑sheet amendments to Substitute House Bill 12 that would force insurers to pay valid health‑care claims quickly and require insurers to pay before providers collect patients’ shares. The House amended the bill on the floor but ultimately circled the substitute for further work after disputes over the 10‑day rule.
Representatives on the House floor engaged in an extended debate over Substitute House Bill 12, a measure dealing with payment of health‑care claims, ultimately agreeing to circle the substitute for further work.
Representative Glenn Brown introduced pink‑sheet amendments that would require an insurer to pay a valid health‑care claim “within 10 working days from the date the claim is received by the insurer,” and would prevent providers from demanding prepayment for procedures that are covered by a policy until the insurer has paid its portion. Brown said the changes were intended to protect insured patients who currently face provider pressure for payment while insurers delay settlement.
Opponents cautioned that the 10‑day requirement is unworkable in many circumstances. Representative Stevens and others pointed to the Unfair Claims Settlement Practices Act already on the books and warned about conflicts with existing administrative rules, the complexity of claims processing (including cases that require additional documentation or peer review), and the disproportionate impact on ERISA‑exempt, self‑funded plans. Several members argued the term ‘claim submitted’ was vague; after floor amendments the wording was changed to ‘received by the insurer’ to clarify when the clock would start.
The House divided the amendment and voted separately on the first part (the 10‑working‑day requirement) and on the remaining items (notification requirements, limits on conditioning admission or release on prepayment, and related changes). Both votes passed on the floor, and the substitute was amended. Subsequent motions to delete the 10‑day provision failed to secure agreement, and after continued debate the body agreed to circle the substitute bill to allow more work on the language and implications for different kinds of claims and insurers.
Representative Glenn Brown argued the amendment was a consumer protection measure to prevent insured individuals from being pursued for bills before insurers pay. Opponents, including representatives who cited practical concerns about claim completeness, national carriers’ processing, and potential unintended consequences for billing practices, urged careful reworking in committee or the interim. The Speaker called the motion to circle the bill, and the motion passed; SHB12 was circled for further consideration.
