HD 1256 Massachusetts House · 194th Legislature (2025-2026)

An Act relative to uncollected co-pays, co-insurance and deductibles

This bill requires health insurance carriers to reimburse healthcare providers 65% of unpaid patient co-pays, co-insurance, and deductibles after providers make documented reasonable collection efforts (e.g., 120+ days of contact attempts). It directly affects healthcare providers who struggle to collect these patient payments, particularly for claims over $250 per unique service. Providers must submit annual aggregated requests by May 1 with documentation of collection efforts, and carriers must pay within 120 days of receiving valid submissions. The law aims to reduce provider financial strain from uncollected patient costs while referencing CMS guidelines for collection standards.
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P
Photo of Carole Fiola
Carole Fiola
DDemocratic
MA
6th Bristol