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Senate committee moves bill to curb insurer recoupments and ban post-payment downcoding after lengthy provider testimony
Summary
House Bill 12-71 would require hospitals to notify patients about payment assistance, ban downcoding that re-prices care after it's been provided, require 60-day notice before reimbursement reductions, and limit audits/recoupments; committee adopted an amendment changing the lookback to one year and advanced the bill after extensive testimony from providers and hospitals.
House Bill 12-71, presented to the Senate Committee on Health and Provider Services, seeks to set baseline fairness and predictability for how insurers handle claims after care has been delivered. The bill requires hospitals to notify patients of payment-assistance and charity-care options at registration/discharge and with the first bill, bans unilateral downcoding that reclassifies services to a lower-paid code after care has been provided, and limits retroactive recoupment and audit windows.
The bill's sponsor described the measure as preserving patients from avoidable medical debt and protecting providers from…
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