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HB 25-1151

signed

Arbitration of Health Insurance Claims

Plain-English Summary

AI-generated

House Bill 25-1151, also known as the Arbitration of Health Insurance Claims bill, aims to make it easier for healthcare providers and insurance companies to resolve disputes over out-of-network claims. It allows multiple related claims to be combined into a single arbitration case, reducing costs by charging only one fee for all these claims together. The bill also requires insurance companies to provide more detailed information about claim payments to healthcare providers. Since the bill has been signed, it is now law and its provisions will be implemented according to the rules set by the commissioner of insurance.

Official Summary

The bill makes changes to the arbitration requirements for out-of-network health insurance claims by requiring the arbitration process to include a batching process, by which multiple claims may be considered jointly and under the same arbitration fee as part of one payment determination in alignment with federal law. The commissioner of insurance is required to adopt rules that specify the information each insurance carrier is required to submit to a provider with the initial payment of a claim.(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Details

Chamber
House
First action
2025-04-10
Latest action
2025-01-29
Last action desc.
Introduced In House - Assigned to Health & Human Services
OpenStates
View source ↗

Sponsors

Related Legislation

This bill affects (14)

amends
SB 24-163(2024A)· signed
Arbitration of Health Insurance Claims
amends
SB 18-237(2018A)· signed
Out-of-network Providers Carriers Required Notices
amends
SB 18-146(2018A)· signed
Freestanding Emergency Departments Required Consumer Notices
amends
HB 17-1094(2017A)· signed
Telehealth Coverage Under Health Benefit Plans
amends
SB 17-206(2017A)· failed
Out-of-network Providers Payments Patient Notice
amends
SB 17-249(2017A)· signed
Sunset Division Of Insurance
amends
HB 18-1358(2018A)· signed
Health Care Charges Billing Required Disclosures
amends
SB 22-068(2022A)· signed
Provider Tool To View All-payer Claims Database
amends
HB 22-1284(2022A)· signed
Health Insurance Surprise Billing Protections
amends
SB 24-135(2024A)· signed
Modification of State Agency & Department Reporting Requirements
amends
HB 24-1149(2024A)· signed
Prior Authorization Requirements Alternatives
amends
HB 25-1002(2025A)· signed
Medical Necessity Determination Insurance Coverage
relates
SB 17-133(2017A)· failed
Insurance Commissioner Investigation Of Provider Complaints
relates
SB 18-115(2018A)· signed
Apply Stark Laws To Medical Referrals Outside Medicaid

Affected by (6)

amends
HB 25-1174(2025A)· signed
Reimbursement Requirements for Health Insurers
amends
HB 26-1069(2026A)· signed
Availability of Emergency Medical Services
relates
HB 25-1002(2025B)· signed
Corporate Income Tax Foreign Jurisdictions
relates
HB 26-1267(2026A)· failed
Limitations on Collection Actions for Medical Debt
relates
HB 26-1002(2026A)· signed
Provider Participation in Health Insurance
repeals
HB 25-1088(2025A)· signed
Costs for Ground Ambulance Services

Votes

BILL
2025-02-28 · House · passYes: 40 · No: 21 · Other: