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Bill Summary · HB 1295

Summary of House Bill 1295: Healthcare Cost-Sharing Collections Transparency Act

Purpose of the Bill

House Bill 1295 aims to establish the Healthcare Cost-Sharing Collections Transparency Act in Arkansas. The primary intent of the bill is to enhance transparency in the collection of healthcare cost-sharing amounts (such as copayments, coinsurance, and deductibles) from enrollees by healthcare insurers.

Key Provisions

The bill includes several significant provisions:

  1. Responsibility for Cost Sharing:

    • Healthcare insurers are mandated to pay healthcare providers the full amount due for services rendered, including any cost-sharing amounts.
    • Insurers would be solely responsible for collecting these cost-sharing amounts from enrollees after the healthcare services have been provided.

  2. Cost Sharing Collection Plans:

    • Enrollees can request a cost-sharing collection plan, allowing them to make payments over time in manageable increments.

  3. Financial Impact:

    • The fiscal impact statement estimates that the annual cost to the Employee Benefits Division (EBD) could range from $10 million to $30 million, representing approximately 1.3% to 3.8% of the Plan’s total projected claims.

  4. Transparency and Reporting Requirements:

    • Insurers must file an annual financial statement with the Insurance Commissioner detailing their financial condition, including total assets, liabilities, and claims paid.

  5. Prohibition on Premium Increases:

    • The bill includes provisions that prevent insurers from increasing premiums or cost-sharing under specific conditions, particularly for fully insured plans.

Who Would Be Affected

  • Healthcare Insurers: The bill imposes new responsibilities on insurers regarding the collection of cost-sharing amounts.
  • Enrollees: Individuals covered under health benefit plans would benefit from clearer processes for managing their cost-sharing obligations.
  • Healthcare Providers: Providers would receive full payment from insurers upfront, reducing the burden of collecting payments from patients.

Procedural Aspects

  • Introduced: January 29, 2025
  • Status: The bill died in the House at Sine Die adjournment on May 5, 2025.
  • Amendments: The bill underwent several amendments, including changes to definitions and reporting requirements, before being engrossed.

Conclusion

While HB 1295 aimed to improve the transparency and efficiency of healthcare cost-sharing collections, it ultimately did not advance through the legislative process. The proposed changes could have had significant implications for how healthcare costs are managed in Arkansas, particularly in terms of financial responsibility and administrative processes for insurers and enrollees alike.

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

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