Defines downcode as the process of changing claims to lower-cost healthcare service than what was in original claim that provider submitted or billed to contracting entity.
Also, requires contracting entity that downsides a claim submitted by healthcare provider, to provide notice of the downcoding, within 30 days of claims processing.
Legislative History
On Jan. 28, 2025, bill introduced in House; on Feb. 11, 2025, bill passed in House.
On Feb. 11, 2025, bill introduced in Senate; on Feb. 19, 2025, bill passed in Senate.
On Feb. 19, 2025, bill returned to House; on Feb. 20, 2025, bill sent to governor.
On Feb. 25, 2025, bill was approved by the governor and then assigned Act 136.
Effectiveness
Act effective 91 days after legislature adjourned sine die (May 5), so Aug. 4, 2025.
Regulators
ARK LEG
Entity Types
Ins
Reference
Act 136, PR, Bill HB1285, 2/25/2025; Citation: ARK INS 23-3-99-12-23-99-1202;
