Contracts Between Carriers And Providers

With regard to a contract between a health insurance carrier (carrier) and a licensed health-care provider (provider) for the provision of health-care services to covered persons under a health coverage plan issued by the carrier (contract), the act:

• Requires the carrier to offer at least one method of payment to the provider for which there is not an associated fee; and
• Prohibits the carrier from restricting the form or method of payment the carrier uses to make payments to the provider so that the only acceptable payment method is a credit card payment.

If a carrier initiates a payment to a provider using, or changes the payment method to, electronic funds transfer payments, including virtual credit card payments, the act requires the carrier to:

• Notify the provider of any fees associated with the particular payment method;
• Advise the provider of the available payment methods and include instructions on how to select an alternative available method; and
• With each payment, remit an explanation of benefits.

The act prohibits a carrier from charging a fee for a change in the payment method to a specified electronic transaction and allows a provider's billing service to charge a fee under certain circumstances.

The act grants enforcement authority to the commissioner of insurance.

APPROVED by Governor April 10, 2023

EFFECTIVE August 7, 2023

NOTE: This act was passed without a safety clause and takes effect 90 days after sine die.
(Note: This summary applies to this bill as enacted.)