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Bill

Bill

A 8172

Relates to establishing timeframes for the payment of claims to hospitals

2025 Regular Session Introduced by Al Stirpe

Sets fixed deadlines for insurers to pay hospitals, improving payment timeliness and hospital cash flow by enforcing timely reimbursements.

REFERRED TO INSURANCE
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WeVote Research Nonpartisan
Bill Summary · A 8172

Summary of Bill A 8172

Overview

  • Bill Number: A 8172
  • Title: Relates to establishing timeframes for the payment of claims to hospitals
  • Status: REFERRED TO INSURANCE
  • Introduced: May 5, 2025
  • Sponsor: Albert A. Stirpe (primary)
  • Related companion: S 8590 (listed as companion)

Note: The available information provides only the bill’s title and basic status. The text of the provisions is not provided here, so specifics on deadlines, definitions, and enforcement are not yet confirmed. The companion bill cited is S 8590.

Purpose and Intent

  • The bill aims to establish statutory timeframes for the payment of hospital claims. In broad terms, this would set fixed deadlines by which insurers or other payers must pay hospitals for submitted claims, with the goal of improving payment timeliness and hospital cash flow.

Key Provisions (What to look for in the full text)

  • Defined payment deadlines: Specific number of days within which a payer must process and remit payment after a claim is submitted.
  • Scope and definitions: What counts as a “claim,” which hospitals are covered, and which payers are subject to the payment timeframes.
  • Handling of disputed or incomplete claims: How delays due to disputes or missing information would be treated.
  • Penalties or remedies: Potential penalties, interest, or compliance remedies for late payments.
  • Enforcement and oversight: Mechanisms to enforce deadlines (e.g., penalties, audits, reporting requirements).
  • Reporting and accountability: Any required reporting on payment timeliness and compliance.
  • Exemptions or special cases: Any carve-outs for certain types of claims or payer programs (not specified here; to be clarified in the text).

Affected Parties

  • Primary: Hospitals that submit claims to payers.
  • Payers: Insurance companies and other entities responsible for reimbursing hospital claims.
  • Indirectly: Patients and health care providers who rely on timely hospital payments.

Procedural Status and Timeline

  • Introduced: May 5, 2025.
  • Legislative action: Referred to the Insurance committee on May 5, 2025 (listed twice in the record).
  • Relationship to companion: S 8590 is identified as a companion bill, suggesting parallel or similar legislation in another chamber.

Potential Impacts

  • Hospitals: Improved predictability of cash flows and faster reimbursement.
  • Payers: Administrative changes to meet defined deadlines; potential need for process improvements and systems updates.
  • Healthcare costs: Depending on the cost of compliance and any penalties, there could be indirect effects on payer expenses and, subsequently, premiums or service pricing (not specified in the text).
  • Administrative burden: Possible increased compliance and reporting requirements for payers.

Next Steps

  • Review the full bill text to confirm the exact deadlines, definitions, exemptions, penalties, and enforcement mechanisms.
  • Monitor committee hearings and potential amendments in the Insurance committee.
  • Consider the companion S 8590 for cross-chamber alignment and potential differences.

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

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