UTA LEG Workers' Comp Balance Billing

Updated on: Mar 31, 2025

Latest Event


  • Mar. 2025 UTA LEG Governor Approval
  • On Mar. 26, 2025, UTA LEG governor approved bill SB 190, effective on May 7, 2025.

On Feb. 28, UTA LEG enrolled bill to expand prohibitions to providers.

  • UTA LEG passed Bill SB 190 to expand prohibition of balance billing for workers' comp.
  • Provisions amended Workers' compensation act in Utah code UTA LEG 34A-2-4-407.
  • Bill Provisions
  • Added definitions related to balance billing, health care and workers' compensation.
  • Employee claiming benefits under Utah occupational disease act, UTA LEG 34A-3-1-101, will comply with disclosure obligations re records for work-related injury claim.
  • Employee banned from claim of injury benefits if he/she fails to provide timely notice.
  • Commission may require reports for reported injury after consulting with the workers' compensation advisory council, and employer must timely file the reported injury.
  • Health care provider required to comply with rules re covered medical services fees (other than hospital fees), reimbursement, work injury claims, and relevant reporting.
  • The commission's fee schedule may reasonably differentiate the compensation paid to health care providers for covered medical services based on injury severity, treatment.
  • Health care provider prohibited from engaging in balance billing, and when treating an injured employee, may provide initial report to employee, employer, and the division.
  • Legislative History
  • On Jan. 30, 2025, bill introduced in Senate; on Feb. 12, 2025, bill passed in Senate.
  • On Feb. 13, 2025, bill delivered to House; on Feb. 26, 2025, bill was passed in House.
  • On Feb. 26, 2025, bill returned to Senate; on Feb. 28, 2025, bill was sent for enrolling.
  • Effectiveness
  • Bill SB 190, if approved, becomes effective as of May 7, 2025.
  • Mar. 2025 UTA LEG Governor Approval
  • On Mar. 26, 2025, UTA LEG governor approved bill SB 190, effective on May 7, 2025.
Regulators
UTA LEG
Entity Types
CNSM; Corp; Ins
Reference
Act, 3/26/2025; Bill SB0190, 2/28/2025; Citation: *UTA LEG* 34A-2-4-407, 34A-3-1;
Functions
Claims/Accelerated Benefits; Compliance; HR; Legal; Operations
Countries
United States of America
Category
State
N/A
Products
Corporate; Insurance; Workers Comp
Rule Type
Final
Regions
Am
Rule Date
Feb 28, 2025
Effective Date
May 7, 2025
Rule ID
245268
Linked to
N/A
Reg. Last Update
Mar 26, 2025
Report Section
US Insurance