SSB 5683
In CommitteeSenate
Health carrier payment times
Concerning health carrier transparency of payment timeliness of claims submitted by health care providers and health care facilities.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill requires health insurers, health plans, and managed care organizations to report detailed data on how quickly they pay providers’ claims, with the goal of increasing transparency and reducing payment delays that hurt providers and potentially impact patient care. The state will then publish this data annually to help identify trends and improve accountability.
- Requires health insurance carriers, health plans, and managed care organizations to report annual data on claims payment timeliness to state agencies, starting January 1, 2027.
- Mandates reporting of metrics including total claims submitted, clean vs. non-clean claims, requests for additional information, and average and range of days for payment after claim submission or information request.
- Defines ‘clean claim’ as a claim with no defects or missing documentation that would delay payment.
- Requires the Office of the Insurance Commissioner and Health Care Authority to publish annual public reports—including carrier/plan identity, complaint summaries, and trend analysis—by July 1, 2027, and each year thereafter.
- Applies to all health plans offered to public employees, retirees, and dependents under state law.
Who is affected
- Health care providers and facilities — Health care providers (like doctors, clinics, and hospitals) and health care facilities that submit insurance claims will face increased administrative transparency but may benefit from reduced payment delays due to public reporting of payment timeliness data.
- Health insurance carriers, health plans, and managed care organizations — Health insurance carriers, health plans, and managed care organizations must begin collecting and reporting detailed claims payment data starting in 2027.
- Public employees, retirees, and their dependents — Public employees, retirees, and their dependents covered under state-offered health plans will be affected as those plans must also report payment timeliness data.
- State agencies (Office of the Insurance Commissioner and Health Care Authority) — State agencies—specifically the Office of the Insurance Commissioner and the Health Care Authority—will gain new reporting responsibilities and must publish annual public reports on payment timeliness.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (4)
Public, standardized reporting of claims payment timelines will empower providers (especially small clinics and rural hospitals) to identify patterns of delay, negotiate more effectively with payers, and potentially reduce administrative costs tied to chasing late payments — improving cash flow and sustainability.
HealthcarePeopleRef: Sec. 1(2), Sec. 2(1)(e)-(f), Sec. 3(1)(e)-(f), Sec. 4(1)(e)-(f)Transparency will help patients and policymakers identify systemic delays that contribute to provider financial stress and potential reductions in care access — especially in underserved areas where provider margins are thin and delays can threaten viability.
HealthcarePeopleRef: Sec. 1(1), Sec. 2(3)(a)-(d), Sec. 3(3)(a)-(d), Sec. 4(3)(a)-(d)Requiring reporting of claims paid within 30 days creates a clear benchmark for performance, enabling providers and advocates to hold insurers accountable and push for faster payment practices — aligning with federal timely-payment standards (e.g., CMS 30-day rule for Medicare).
HealthcarePeopleRef: Sec. 2(1)(g), Sec. 3(1)(g), Sec. 4(1)(g)Statewide trend analysis may reveal patterns of systemic underpayment or delays that correlate with gaps in care access — informing future policy interventions to protect continuity of care and prevent provider closures.
Public SafetyPeopleRef: Sec. 2(3)(b), Sec. 3(3)(b), Sec. 4(3)(b)
Potential Concerns (4)
Increased administrative burden on health insurers and plans may lead to higher operational costs, which could be passed on to employers and enrollees in the form of higher premiums or reduced benefits over time — especially if systems are not modernized to absorb the reporting workload efficiently.
HealthcarePeopleRef: Sec. 2(1)(d)-(f), Sec. 3(1)(d)-(f), Sec. 4(1)(d)-(f)State agencies (OIC and HCA) will need to hire or reassign staff and potentially upgrade IT infrastructure to collect, verify, analyze, and publish the required annual reports — diverting resources from other high-priority regulatory or programmatic functions.
Local GovernmentLean peopleRef: Sec. 2(3)(d), Sec. 3(3)(d), Sec. 4(3)(d)The bill grants regulators broad discretion to require “such other information as specified,” which introduces uncertainty for insurers and plans about future reporting expectations and may create inconsistent or evolving compliance costs.
Business & EmploymentLean peopleRef: Sec. 2(1)(h), Sec. 3(1)(h), Sec. 4(1)(h)Publishing complaint summaries alongside payment data without context or verification could mislead the public or unfairly stigmatize insurers, potentially eroding trust in the system even when complaints are resolved or unfounded.
Public SafetyPeopleRef: Sec. 2(3)(c), Sec. 3(3)(c), Sec. 4(3)(c)
Who Is Most Affected
Small- and medium-sized clinics, especially those in rural or safety-net settings, are most vulnerable to payment delays. This bill gives them data to advocate for faster payments and potentially reduce bad debt and billing overhead.
Large health plans and insurers already have robust reporting systems; compliance costs will be relatively low, but they may face reputational risk if their payment speed ranks poorly compared to peers — potentially pressuring them to improve practices.
Public employee health plans (e.g., LEOSE, PEBH) must comply with reporting, but since they are state-administered, implementation is likely smoother than for private insurers — and transparency may improve accountability to enrollees.
OIC and HCA staff will face new data collection and analysis responsibilities, but the bill does not appropriate new funding — meaning staff may need to divert time from other regulatory priorities.
Hospitals and health systems with large billing departments may benefit from faster payments and reduced dispute resolution costs, but larger institutions may be less affected overall due to existing billing infrastructure and leverage with payers.