HB304 Alabama 2010 Session

Summary

Primary Sponsor

Ron Johnson

Republican

Session

Regular Session 2010

Title

Health benefit plans and health insurance companies, desk audits of claims of health care providers, costs of copies of records and files to be paid by health benefit plan

Summary

HB304 would require health benefit plans to reimburse health care providers for costs related to desk audits of claims.

What This Bill Does

It would require a health benefit plan to reimburse costs tied to desk audits when provider records are forwarded to the plan for the plan's convenience. It would cover direct and indirect costs of providing records and other documentation to the plan at a location chosen by the plan. Desk audits are defined as audits conducted on the plan's premises reviewing provider records and do not include information sought about the initial submission of a claim or related appeals; the bill applies to plans that process claims for Alabama residents, with certain exclusions, and it takes effect immediately after passage and approval.

Who It Affects

• Health care providers (doctors, clinics, and other providers) who submit claims and may incur costs for providing records, now eligible for reimbursement from health benefit plans.
• Health benefit plans/insurers operating in Alabama or processing claims for Alabama residents, which would be responsible for reimbursing providers for desk-audit related costs and covering associated record-keeping costs.

Key Provisions

• Desk audit is defined as a plan-conducted review of provider records on the plan's premises, excluding information sought about the initial submission of a claim or its appeals.
• Health benefit plans must reimburse providers for costs related to desk audits, including direct and indirect costs of providing records and documentation at a plan-chosen location for the plan's convenience.
• The act applies to plans that pay for insured health services in Alabama (including some out-of-state plans that process Alabama claims), but excludes certain limited-benefit policies such as accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, and similar policies.
• The act becomes effective immediately upon passage and approval by the Governor.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health