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Providers urge transparency as insurers warn HB 4054 could add costly mandates
Summary
Medical providers said automatic 'downcoding' by AI and automated tools undercuts reimbursements and urged HB 4054's disclosure and appeals requirements; insurers and trade groups warned the bill would duplicate existing standards, conflict with national codes and raise administrative costs.
House Bill 4054, which would require insurers to notify providers each time artificial intelligence or other automated technology automatically downcodes a claim and to provide an appeals process, brought a large and divided witness list to the committee on Feb. 6.
Sabrina Riggs, representing a coalition of provider groups including the Oregon Independent Medical Coalition, described increased batching and automated adjustments and said the bill seeks transparency not a ban: "This is only a transparency bill," she told the Joint Committee on Information Management and Technology.
Provider…
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