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Bill

HB 917

Health Insurance - Retroactive Denial of Reimbursement

2026 Regular Session Introduced by Tiffany Alston and 4 co-sponsors

HB 917 limits health insurers' ability to deny reimbursement for previously authorized or delivered medical services after treatment, protecting patients from unexpected bills.

First Reading Health
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Bill Summary · HB 917

Legislative bill overview

HB 917 addresses the practice of health insurers retroactively denying reimbursement for medical services that were previously authorized or provided. The bill would establish limitations on when and how insurance companies can deny payment for healthcare services after the fact. This represents an effort to protect patients and providers from unexpected financial liability for services already rendered.

Why is this important

Retroactive denials create significant hardship for both patients and healthcare providers. Patients may face unexpected bills for services they believed were covered, while providers lose revenue for care already delivered. This practice can delay necessary medical treatment if patients fear financial consequences, and creates administrative burden when disputes must be resolved after treatment occurs.

Potential points of contention

  • Insurance industry costs: Insurers argue retroactive denials are necessary enforcement tools against fraud and billing errors; restricting this authority could increase premiums or reduce coverage options
  • Definition and scope: Determining what constitutes a valid retroactive denial versus an improper one will be crucial—the bill's specific language matters greatly for implementation
  • Fraud prevention balance: Policymakers must weigh patient protection against the need to prevent fraudulent claims, which retroactive review mechanisms currently help detect

Compiled from official sources — confirm details with the bill’s official record.

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