HB 1015: Insurance Claims Payments to Health Care Providers
GENERAL BILL by Cassel
Insurance Claims Payments to Health Care Providers; Prohibits payment adjudicators from downcoding health care services under certain circumstances; requires health insurers to ensure that their downcoding policies are updated & to ensure compliance with specified provisions on downcoding; authorizes investigations & actions against noncompliance; provides certain presumption in favor of physicians' determination regarding patients' diagnoses & service orders; provides calculations of interests on health insurers' nonpayment & underpayment due to downcoding; provides causes of action for health care providers; prohibits utilization review entities from implementing new requirements, restrictions, & changes on prior authorizations under certain circumstances; provides requirements for adverse determinations made by such entities on health care providers' claims; revises requirements & timeframes for responses from health insurers & HMOs to submitted claims.
Last Action: 1/12/2026 House - Now in Insurance & Banking Subcommittee
Bill Text: PDF
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Bill History
Date Chamber Action 1/5/2026 House • Filed
1/12/2026 House • Referred to Insurance & Banking Subcommittee
• Referred to Health Care Facilities & Systems Subcommittee
• Referred to Commerce Committee
• Now in Insurance & Banking Subcommittee
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HB 1015, Original Filed Version (Current Bill Version) Posted 1/5/2026 at 4:10 PM
Bill Text: PDF Analyses: None Related Bills (1)
Bill Number Subject Filed By Relationship Last Action and Location Track Bills S 1130 Insurance Claims Payments to Health Care Providers Massullo Similar Last Action: 1/12/2026 S Referred to Banking and Insurance; Appropriations Committee on Agriculture, Environment, and General Government; Fiscal Policy 
Citations - Statutes (5)
Citation Catchline Location in Bill Location In Bill Help 395.1065 Criminal and administrative penalties; moratorium. Page 64 (pdf) 627.4193 Page 3 (pdf) 627.42392 Prior authorization. Page 8 (pdf) 627.6131 Payment of claims. Page 23 (pdf) 641.3155 Prompt payment of claims. Page 45 (pdf)