SB164
Health insurance; ethics and fairness in carrier business practices, downcoded claims.
Status:
Passed
Latest Action:
March 24, 2026
Senate: Fiscal Impact Statement from State Corporation Commission (SB164)
Chief Patron:
Jeremy McPike (D)
Session:
2026 Regular Session
Summary
As Passed House of Origin. Health insurance; ethics and fairness in carrier business practices; downcoded claims.
Prohibits a carrier, intermediary, administrator, or representative of a carrier from downcoding a claim, as defined in the bill, unless the decision to downcode is determined by a person or electronic system that considers all relevant patient data from the billing provider in making the determination. The bill requires a ... (More) carrier, intermediary, administrator, or representative that downcodes a claim to provide certain notice to the person submitting the claim, including the reason for the decision and the process to appeal. The bill requires that all downcoding dispute decisions shall be adjudicated by a natural person.(Less)
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Bill History
- 01/07/2026 - Senate: Prefiled and ordered printed; Offered 01-14-2026 26103299D
- 01/07/2026 - Senate: Referred to Committee on Commerce and Labor
- 01/26/2026 - Senate: Senate committee offered
- 01/26/2026 - Senate: Senate committee offered
- 01/26/2026 - Senate: Reported from Commerce and Labor with substitute (15-Y 0-N)
- 01/27/2026 - Senate: Committee substitute printed 26106195D-S1
- 01/28/2026 - Senate: Rules suspended
- 01/28/2026 - Senate: Constitutional reading dispensed Block Vote (on 1st reading) (40-Y 0-N 0-A)
- 01/28/2026 - Senate: Passed by for the day Block Vote (Voice Vote)
- 01/28/2026 - Senate: Passed by for the day
- 01/29/2026 - Senate: Read second time
- 01/29/2026 - Senate: Commerce and Labor Substitute agreed to
- 01/29/2026 - Senate: Engrossed by Senate (Voice Vote)
- 01/29/2026 - Senate: Engrossed by Senate - committee substitute
- 01/30/2026 - Senate: Read third time and passed Senate
- 02/04/2026 - House: Placed on Calendar
- 02/04/2026 - House: Read first time
- 02/04/2026 - House: Referred to Committee on Labor and Commerce
- 02/18/2026 - House: Placed on Labor and Commerce Agenda
- 02/19/2026 - House: Assigned HCL sub: Subcommittee #1
- 02/23/2026 - House: Placed on Labor and Commerce Agenda
- 02/24/2026 - House: Subcommittee recommends reporting with substitute (9-Y 0-N)
- 02/25/2026 - House: Placed on Labor and Commerce Agenda
- 02/26/2026 - House: Reported from Labor and Commerce with substitute (21-Y 0-N)
- 02/27/2026 - House: Committee substitute printed 26108190D-H1
- 03/02/2026 - House: Read second time
- 03/03/2026 - House: Moved from Uncontested Calendar to Regular Calendar
- 03/03/2026 - House: Passed by for the day
- 03/03/2026 - Senate: Fiscal Impact Statement from State Corporation Commission (SB164)
- 03/04/2026 - House: Read third time
- 03/04/2026 - House: committee substitute rejected
- 03/04/2026 - House: Passed by temporarily
- 03/04/2026 - House: Floor Offered
- 03/04/2026 - House: Reconsideration of
- 03/04/2026 - House: Labor and Commerce Substituteagreed to by House
- 03/04/2026 - House: Delegate Shin Floor amendments agreed to
- 03/04/2026 - House: Engrossed by House - committee substitute as amended
- 03/04/2026 - House: Passed House with substitute with amendments (97-Y 1-N 0-A)
- 03/06/2026 - Senate: House substitute with amendments agreed to by Senate (40-Y 0-N 0-A)
- 03/12/2026 - Senate: Enrolled
- 03/12/2026 - Senate: Bill text as passed Senate and House (SB164ER)
- 03/12/2026 - House: Signed by Speaker
- 03/12/2026 - Senate: Signed by President
- 03/14/2026 - Senate: Enrolled Bill communicated to Governor on March 14, 2026
- 03/14/2026 - Governor's Action Deadline 11:59 p.m., April 13, 2026
- 03/24/2026 - Senate: Fiscal Impact Statement from State Corporation Commission (SB164)
