Relating to timely submission of claims by health care providers to health insurers

Sponsored by the Senate Commerce Committee

Topics:Business & economy Health care Medicaid

Same legislation: SSB 1202

Write your legislators about it

Official bill page Lobbyist declarations One-pager to print

Where it is now

Done: IntroducedMarch 6, 2019
Done: SubcommitteeJanuary 14, 2020
Done: Senate committeeMarch 6, 2019
Stopped: Passes the SenateDied when the General Assembly ended
Next: House committee
Next: Passes the House
Next: To the Governor
Next: Signed into law

Died when the session ended The 2020 session adjourned on June 14, 2020, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?

What’s in it

AI summary Health care providers will have up to one year to send claims to health insurers for services they provided. They also have one year from a final decision to ask an insurer to look at a claim again. If a provider waits more than two years to submit a claim, the insurer does not have to pay it. These rules apply to most health insurers and providers but do not include Medicaid.¹

Read the official explanation

This bill relates to the timely submission of claims by health care providers to health insurers. The bill defines “health insurer”, “health care provider”, and “health care services”. The bill provides that a health care provider shall have up to 365 days after the date of the provision of health care services to submit a claim to a health insurer. The provider has up to 365 days from the date of the last adjudication by a health insurer to resubmit a claim for adjustment or reconsideration. A claim submitted two or more years from the date of provision of health care services shall not be paid by an insurer. These provisions of the bill apply to all health insurers and health care providers except Medicaid providers and Medicaid managed care organizations. The bill makes conforming changes.

Full bill text²

Senate subcommittee

Named January 14, 2020. It hasn’t reported yet.

Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part

Iowa Code it changes

Creates§507B.04B

Amends§507B.12 §507B.4 §507B.4A §507B.6 §514F.6

How the Code works³

Lobbying

4 for · 1 against · 24 undecided · Who →

Family tree

Study bill

SSB 1202Cleared committee

88th General Assembly

SF 504Cleared committee