State Laws

Search state statutes and regulations in all 50 states and the District of Columbia to find out what rights you have in your state and what other states are doing to empower physicians and patients in the face of health insurer market power.

State Law

Indiana Code-Title 27-Article 8-Chapter 5.7-Accident and Sickness Insurance; Provider Payment

07/12/2023 Indiana Sections 27-8-5.7-2, 27-8-5.7-2.5, 27-8-5.7-3, 27-8-5.7-5, 27-8-5.7-6, 27-8-5.7-6.5, 27-8-5.7-8, 27-8-5.7-10, 27-8-5.7-11

“Clean Claim” Defined; “CPT Code” Defined; “Insurer” Defined; Notice of Deficiencies in Claims; Payment or Denial of Claims, Interest; Limitations on an insurer’s ability to alter CPT code or pay for a CPT code of lesser monetary value; Civil Penalties; Claim Payment Errors; Claim Overpayment Adjustment

Overpayments / Recoupments, Payment Edits, Prompt Payment Deadlines
State Law

Maryland Statutes-Article 15. Insurance

08/07/2023 Maryland Section 15-113

Health Insurance – Two–Sided Incentive Arrangements

Amendments, Fee Schedules, Overpayments / Recoupments, Participation in Products, Plans, or Networks, Payment Edits, Payment Rules, Prohibited financial incentives, Prompt Payment Deadlines, Risk—Physicians Taking
Ama Policy

Insurance Companies Use of Contractors to Recover Payments D-385.965

10/14/2019
Overpayments / Recoupments
State Law

Arkansas Insurance Department-Finalized Rules-Rule 85 (054.00.05-006)

07/28/2023 Arkansas Rule 85 (054.00.05-006)

Recoupment

Overpayments / Recoupments
Ama Policy

Medicare and Insurance Takeback Procedures H-320.943

03/14/2019
Overpayments / Recoupments
Ama Policy

Insurance Company Filing Deadlines H-190.979

03/13/2019
Overpayments / Recoupments
Ama Policy

Insurance Reimbursements D-190.977

03/13/2019
Overpayments / Recoupments
State Law

Utah Code-Title 31A-Chapter 26-Part 3. Claims Practices

08/25/2023 Utah Section 31A-26-301.6

Health care claims practices

Anti-retaliation, Fee Schedules, Overpayments / Recoupments, Prompt Payment Deadlines
State Law

Texas Admin. Code-Title 28-Part 1-Chapter 11-Subchapter J. Physician and Provider Contracts and Arrangements

08/24/2023 Texas Section 11.901

Required and Prohibited Provisions

Amendments, Anti-retaliation, Continuity of Care Post-Contract, Fee Schedules, Liability-insurer shifting to physician, Overpayments / Recoupments, Payment Edits, Prompt Payment Deadlines, Termination, Termination-Due Process