H1335: Payment of Health Insurance Claims

Legislative Summary

Prohibits health insurer & health maintenance organization from retroactively denying claim at any time because of ineligibility of insured & subscriber; specifies exception; requires health insurer & HMO to provide accurate information to provider about insurer's & subscriber's grace period status; authorizes health insurer & HMO to recoup payment retroactively within specified timeframe if such accurate information is given to provider; provides nonapplicability of prohibition to Medicaid managed care plans.