Delaware Senate Bill 143

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Spectrum: Partisan Bill (Democrat 4-0)
Status: Introduced on May 19 2023 - 25% progression, died in committee
Action: 2023-05-19 - Introduced and Assigned to Banking, Business, Insurance & Technology Committee in Senate
Pending: Senate Banking, Business, Insurance & Technology Committee
Text: Latest bill text (Draft #1) [HTML]

This Act makes several changes intended to improve the claims payment process by health insurers. Specifically, the Act: (i) codifies the definition of clean claim adopted in Department of Insurance regulations; (ii) requires an insurer to treat erroneously denied claims as timely filed without the provider having to resubmit the claim; (iii) requires carriers that engaged in coordination of benefits verify an insureds other coverage is effective for the date and type of service associated with the applicable claim before taking any recovery action against a provider; (iv) requires that a carrier who recovers payment from a provider through coordination of benefits and thereafter receives reimbursement for the same claim from another insurer issue notice to the provider of the payment so that the provider may seek payment for the amount recovered; (v) allows a provider 12 months to submit a claim for reimbursement after a retroactive denial by a carrier; (vi) requires prompt payment of clean claims within 30 days and after a successful appeal by a provider from a carriers denial of payment, with interest accruing on late payments. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

An Act To Amend Title 18 Of The Delaware Code Relating To Health Insurance.

Sen. Spiros Mantzavinos [D]

Rep. William Bush [D]

Sen. Jack Walsh [D]

Rep. Paul Baumbach [D]

Date	Chamber	Action
2023-05-19		Introduced and Assigned to Banking, Business, Insurance & Technology Committee in Senate

Type	Source
Summary	https://legis.delaware.gov/BillDetail?LegislationId=140452
Text	https://legis.delaware.gov/json/BillDetail/GenerateHtmlDocument?legislationId=140452&legislationTypeId=1&docTypeId=2&legislationName=SB143