Committee approves amendment to Senate Bill 189 removing hospital penalty and adding IDR oversight

A legislative committee unanimously approved Amendment No. 10 to Senate Bill 189, removing a 10% penalty on hospitals and adding state-level steps aimed at limiting alleged abuses of the independent dispute resolution (IDR) process.

The Chair, speaking at the bill’s third hearing, said the amendment tries to balance concerns raised in earlier meetings and earlier, unsuccessful amendment attempts. "Anybody who files for an IDR will have to notify the facility in which the service happened," the Chair said, describing a notification requirement that would let hospitals track out‑of‑network activity affecting their facilities.

The amendment also sets a trigger for remedial talks: when a carrier faces 25 or more unique IDR challenges in a 90‑day period, the carrier can call a meeting with the hospital, the provider and the insurer to discuss solutions. The Chair described that threshold and other limits as a way to address what they characterized as misuse of IDR: "It's not widespread across the industry, but there are some key players, using it really as a profit center and not just an honest dispute resolution process," the Chair said.

The measure caps such meetings at four per doctor group per payer per year, the Chair said, and aims to encourage more in‑network contracting and more competitive reimbursement where needed. The Chair told the committee the 10% penalty was removed because it felt "disjointed" as a way of addressing what the Chair called an essentially federal issue.

A motion to adopt Amendment No. 10 was seconded and the committee conducted a roll call vote. The transcript records these votes: Representative Campbell — Aye; Representative Dan Chester — Yes; Representative Porter — Aye; Representative Goss Reeves — Yes; Representative Lehman — Yes; Representative Borders — Yes; Representative Mayfield — Aye; Representative Maguire — Yes; Representative Ledbetter — Yes; and Chairman Carball — Yes. The Chair declared the bill passed, 10 to 0.

At the close of the meeting the Chair thanked hospital and insurer representatives for their involvement by name: Brian Burdick, Grant Auchenbach with ISMA and Dave Ober with Anthem. A committee member thanked the Chair on behalf of the ranking minority member and said the group looked forward to conference committees.

The committee adjourned after the vote. No further actions or deadlines were specified on the record.