PROVIDENCE – Gov. Daniel J. McKee has signed legislation to protect patients from having their health insurance claims denied because of their insurer or healthcare provider’s belief that another party may be liable.
The measure was sponsored by Rep. Arthur J. Corvese, D-North Providence, and Sen. Stefano V. Famiglietti, D-North Providence.
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The new law prohibits insurers and healthcare providers from denying the payment of a medical bill solely because the bill may have arisen from a third party’s actions. Although not all insurers engage in the practice, it can occur when a third party is at fault but lacks liability insurance.
The law took effect immediately.
“Existing laws already enable health insurers to recover funds if it is legally determined that the patient’s medical expenses were the result of the actions of a third party – for example, a person driving under the influence,” Corvese said. “But when they deny those medical claims when they are submitted, they are heaping suffering onto the person seeking healthcare, sometimes plunging them into medical debt and potentially bankruptcy, especially if they have to wait for a legal case to resolve. If you have health insurance, your insurance is responsible for your healthcare. If they can recover the costs later because someone else is responsible, they should – after they pay the claim, as existing law allows.”
Famiglietti said, “Claims should not be denied solely because they may be associated with a third-party liability. In addressing this issue, this legislation makes the process more predictable for providers, while maintaining appropriate standards and keeping payments timely and fair.”
