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F I S C A L I M P A C T R E P O R T
SPONSOR Griego
DATE TYPED 1/26/05
HB
SHORT TITLE Health Insurance Claim to Providers
SB 193
ANALYST Wilson
APPROPRIATION
Appropriation Contained Estimated Additional Impact Recurring
or Non-Rec
Fund
Affected
FY05
FY06
FY05
FY06
See Narrative
Relates to SB 371
SOURCES OF INFORMATION
LFC Files
Responses Received From
Public Regulation Commission (PRC)
SUMMARY
Synopsis of Bill
Senate Bill 193 creates a new section in the insurance code under unfair trade practices. This bill
requires that insurers honor the assignment of health insurance claims from their insured’s to the
provider of the medical services. Contracts issued after the effective date could not restrict the
insured’s right to assign such claims.
Significant Issues
Some insurers who operate through preferred provider arrangements or network providers refuse
to honor assignments of the insured’s claim to a non-network provider. Although the provider
can send the statement for services rendered to the insurer they must collect directly from their
insured patient. This can create collection problems unless the provider collects payment at time
of service. This bill would eliminate this practice by mandating that assignments be accepted.