SB 2328 – Tennessee

Status: Enacted
Year Introduced: 2024

This bill focuses on the amendment of Tennessee Code Annotated, Titles 56, 63, and 68, pertinent to the payment for healthcare. It outlines the process for the recoupment of overpaid claims by healthcare insurance entities from healthcare providers. In the bill, ‘recoupment’ refers to the action by a health insurance entity to recover amounts previously paid by withholding or deducting these amounts from current payments to the healthcare provider. The bill stipulates that a healthcare provider’s request for a payment correction must be filed no longer than six months following the date that payment for the claim was received. Unless fraud is committed by the healthcare provider, the health insurance entity can only recoup reimbursements during the six months following the payment date. The bill also lists the necessary information that must be included in a recoupment notice and describes the procedure for appealing a recoupment. If a healthcare provider chooses to appeal, neither entity is allowed to withhold payment until all appeals are exhausted. If a health insurance entity fails to adhere to the bill’s requirements, the commissioner can impose a penalty. The bill also prohibits the waiver, nullification, or voiding of these requirements by any contract. 

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