State/Citation Status of Law State Contact
Alabama

HB164 (2001)

Amends Insurance General Provisions § 27-1-19
Reimbursement of Health Care Providers

Rules of Alabama State Board of Health Bureau of Health Care Standards
Chapter 420-5-6 HMOs
420-5-6.06 (10) 

30 calendar days for clean electronic claims & 45 calendar days for clean written claims.

Interest on overdue claims is 1.5%.

For insurance plans: Alabama Department of Insurance, (334) 269-3550
Alaska

Division of Alaska Insurance Administrative Code

3 AAC 26070

30 days for a clean claim to be paid.  Alaska Division of Insurance

(907) 465-2515

Arizona

Title 20 Insurance
Chapter 2 Transaction of Insurance Business
Article 6 Unfair Practices and Frauds
§ 20-462 Timely Payment of Claims

Claims must be paid within 30 days or the time period specified in the contract.  Interest on overdue claims at a rate that is equal to the legal rate. Arizona Department of Insurance

(800) 325-2548

Arkansas

Insurance Regulations
Rule and Regulation 43
Unfair Claims Settlement Practices

30 days for electronic clean claims and 45 days for non-electronic clean claims. Penalty is 12% per year for late payment. Arkansas Department of Insurance

(800) 282-9134

California

Health and Safety Codes
Division 2. Licensing Provisions Chapter 2.2. Health Care Service Plans, Article 5. Standards
1371.35* Time limits for reimbursement, contest, or denial of certain claims; What constitutes complete claim; Claims exempted from time limits

Insurance Code § 10123.13 Reimbursement of Claims

Claims must be paid within 45 working days for an HMO, 30 days for a health service plan. Interest accrues at 15% per annum. California Department of Managed Healthcare

(800) 400-0815

Colorado

10-16-106.5
Prompt Payment of Claims Legislative Declaration

Title 10 Article 16
106.5 Prompt Payment of Claims - Legislative Declaration, Effective January 1, 2000

As of January 1, 2000, claims must be paid in 30 days if submitted electronically, 45 if not. Penalty is 10% annually.  After 90 days an extra penalty of 10% of the total amount of claim is added. Colorado Division of Insurance

(303) 894-7499

Connecticut

Public Act No. 98-163, Insurance General Statutes § 38a-816
An act concerning health provider billing practices and requiring health insurers to pay or reimburse providers on a timely basis

Claims must be paid within 45 working days. Interest accrues at 15% per annum. Connecticut Department of Insurance (Consumer Affairs)

(860) 297-3800

Delaware

Department of Insurance
Regulation 80
Standards for Prompt, Fair and Equitable Settlement of Claims for Health Care Services

 

Clean claims must be paid in 45 days. Penalty interest at maximum rate allowable to lenders under Title 6 §2301A. Delaware Department of Insurance

(302) 739-4251

 

District of Columbia

Title 31 Ch. 31A Section 331 et faq 2002 Supplement

30 days for clean claim. Interest penalty for overdue claims is 1.5% from 31st to 60th day. 61st to 120th day penalty is 2% and after 120th interest penalty is 2.5%. District of Columbia Department of Insurance

(202) 727-8000

 

Florida

Title 37 § 641.3155 Provider contracts; payment of claims

Electronic clean claims must be paid in 20 days and paper claim paid in 40 days. Interest penalty for overdue claims is 12% per year.

 

Consumer Affairs-Florida Department of Insurance

(850) 413-3100

Georgia

Title 33 Insurance
§ 33-24-59.4

Claims must be paid within 15 days. Interest accrues at 18% per annum. Georgia Office of Insurance (Consumer Services)

(404) 656-2056

Hawaii

Chapter 431:13 Reimbursement for Health Insurance Benefits

Clean, paper claims must be paid in 30 days, electronic claims within 15 days. Interest accrues at 15%. Commissioner may impose fines. Hawaii Medical Association

(808) 536-7702

Idaho Does not have a prompt payment law.  
Illinois

215 ILCS 5/368a

Timely Payment for Health Care Services

 

Clean claims must be paid in 30 days. Interest accrues at 9% per annum. Illinois Department of Insurance

(312) 814-2427

 

Indiana

IC 27-8-5.7 Accident and Sickness Insurance Provider Payment

Paper claims must be paid in 45 days, 30 days for electronic claims.  The interest rate provided under §IC 12-15-27-3(7)(A). Indiana Department of Insurance (Consumer Services)

(317) 232-2385

Iowa

Senate File 500

Section 8
"Duty to respond to Inquiries and Prompt Payment of Claim"

 

Clean claim paid within 30 days. Penalty amount is 10%. Iowa Division of Insurance

(515) 281-5705

Kansas

L.2000 CH.147, Section 43-46

Chapter 40 Insurance
Article 2 General Provisions
40-2,126 Interest due on Insurance Settlements

30 day timeframe
1% fine per month or interest imposed on late payment.
Kansas Department of Insurance, (ask for Accident & Health Services)

(785) 296-3071

Kentucky

KRS 304.17A.702
Claim Payment Time Frame Duties of Insurer

Claims must be paid within 30 working days. Interest accrues at 12% per annum between 31 and 60 days. 18% between 61 and 90 days. 21% after 90 days. Kentucky Department of Insurance

(502) 564-6088

Louisiana

Title 22 R.S. 22:250.31 through 250.37

Claims submitted electronically must be paid within 25 days. Paper claims submitted in 45 days must be paid in 45 days; submitted after 45 days must be paid in 60 days. Penalty is 1% of unpaid balance. An additional 1% penalty is added for each 25 days that the claim remains unpaid. Louisiana Department of Insurance

(225) 342-0895

Maine

Title 24 Insurance Code
Chapter 27 The Insurance Contract
§ 2436 Late Payment

Clean claims must be paid within 30 days. Interest accrues at 1.5% per month. Maine Bureau of Insurance (Ask for Consumer Health)

(207) 624-8475

Maryland

Article - Insurance 15-1005. Prompt Payment of Claims

Clean claims must be paid within 30 days. Interest accrues at monthly rates of 1.5% (31-60 days late), 2% (61-120 days late), and 2.5% (121+ days late). Maryland Insurance Administration

(800) 492-6116

Massachusetts

Chapter 141, Section 20 and 24

Payer must respond within 45 days of receipt of notice for claims reimbursement. Interest accrues at 1.5% per month, not to exceed 18% per year. Massachusetts Division of Insurance, Health Unit of the State Rating Bureau

(617) 521-7349

Michigan

§ 500.2006 Timely payment of benefits or interest; proof of loss

Law applies only to non-contracted providers: Claims must be paid in 60 days, with an interest penalty of 12% per annum. Michigan Insurance Division

(517) 373-0240

Minnesota

Statutes Chapter 62Q.75 Prompt Payment Required

Undisputed or disputed claims paid within 30 days. Interest on overdue claims at 1.5% per month. Minnesota Department of Commerce

(651) 296-4026

Mississippi

Title 83 Insurance
Chapter 9 Accident, Health and Medicare Supplement Insurance 83-9-5 Policy Provisions

25 calendar days after receipt of electronic clean claims and 35 calendar days after receipt of non-electronic clean claims. Interest accrues at 1.5% per month. Mississippi Department of Insurance

(601) 359-3569

Missouri

Missouri Revised Statutes
Chapter 376
Life, Health, and Accident Insurance Section 376.393

H328 (2001)
Amending existing law concerning penalties

 

Claims must be paid, denied, or returned for information within 45 days. Penalty is 1% per month. An additional penalty of 50% of the claim -- not to exceed $20 -- is imposed if the claim is not paid, suspended or denied or if the interest due is not paid within 40 processing days if the provider so notifies the carrier of this delinquency. Missouri Department of Insurance

(573) 751-4126

Montana

Title 33 Insurance and Insurance   Companies
Chapter 18 Unfair Trade Practices
Part 2 Insurer's Relations with Insured and Claimant
33-18-232 Time for Payment of Claims

Clean claims must be paid within 30 days. Interest accrues at 18% per annum. Montana Department of Insurance

(406) 444-2040

Nebraska

Unfair Claim Practices
NE 44-1540

15 working days after claim adjudication is completed.   30 days to pay claim. Nebraska Department of Insurance Consumer Hotline

(877) 564-7323

Nevada

Nevada Revised Statute (NRS)
Chapter 683A.0879

30 days to pay claims. Interest equal to the prime rate at the largest bank in Nevada plus an additional 6%.  Nevada Division of Insurance

(775) 687-4270

New Hampshire

415:6-H Effective 1/1/01
Prompt Payment Required

Payment within 15 days for electronic claims. 45 days for non-electronic claims. Interest 1.5% per month on overdue claims. New Hampshire Department of Insurance

(603) 271-2261

New Jersey

S.B. 323 and A.B. 2121
Effective January 2000

Clean, electronic claims must be paid within 30 days, paper claims within 40 days. Interest on overdue claims at 10% per year. New Jersey Division of Insurance, Life & Health Section, Enforcement & Consumer Protection

(609) 292-5316

New Mexico

Title 13 Insurance
Chapter 10 Health Insurance
Part 13 Managed Health Care

30 days for electronic clean claims and 45 days for non-electronic clean claims. Interest on overdue claims is 1.5% per month. New Mexico Department of Insurance Consumer Division

(505) 827-4601

New York

Chapters 637 and 666 of the Laws of 1997

Claims must be paid within 45 days. Interest accrues at greater of 12% per year or corporate tax rate determined by Commissioner. New York State Insurance Department Consumer Services Bureau

(212) 480-6400

North Carolina

Chapter 58 Insurance
Article 3 General Regulations for Insurance
58-3-100

Plan must notify of claim status within 30 days. No regulation on payment. Interest on overdue claims 18%. North Carolina Department of Insurance

(919) 733-2032

North Dakota

§ 26.1-36-37.1 Standard Health Insurance Proof of Loss Form - Claim Payment Time Limits

Claims must be paid within 15 days. North Dakota Department of Insurance

(701) 328-2440

Ohio

Title 39 Insurance
Chapter 3901 Superintendent of Insurance
Miscellaneous Provisions
§ 3901.381 Prompt Payment of Health Care Providers by Third-Party Payers

Complete claims must be paid 30 days after receipt by the insurance carrier. Interest on overdue claims is 18% a year. Ohio Department of Insurance

(614) 644-2658

Oklahoma

Insurance Code 36
§§ 1219, 1250.5
Delay in Payment of Claims

Title 63 O.S. Section 2514
Reimbursement of Claims within Certain Time Period

Title 74 §1238

Claims must be paid within 45 days.   Interest accrues at 10% per year. Oklahoma Insurance Department

(405) 521-2828

Oregon

Claim Settlement Practices
836-080-0225

30 days to pay claim.   Interest on overdue claims is 12% per year. Oregon Department of Insurance

(503) 947-7984

Pennsylvania

Title 40 P.S. Section 991.2166 Prompt Payment of Claims

Clean claims must be paid in 45 days. Interest is 10% per annum. For claims with HMOs/PPOs, providers must first exhaust carrier appeals process. Pennsylvania Insurance Department

(717) 787-2317

Rhode Island

Prompt Claims Processing.  Title 27, Chapter 18, Section 61

30 days for electronic claims. 40 days for paper claims.  Interest penalty is 12% per year. Rhode Island Department of Insurance

(401) 222-2223

South Carolina

Accident and Health Insurance
38-71-735(J)

Fully insured plan claims must be paid within 60 days, providing all necessary information is received to process claim. South Carolina Department of Insurance

(803) 737-6160

South Dakota

Time limits for processing claims.
58-12-20

30 days for electronic, 45 days for paper claims. South Dakota Department. of Insurance

(605) 773-3563

Tennessee

Title 56 Chapter 7, Section 109
Timely Reimbursement of Health Insurance Claim Act

30 days for non-electronic claims. 21days for electronic clean claims. Interest on overdue claims 1% per month. Tennessee Department of Insurance, Legal Division

(615) 741-2199

Texas

Texas Health Maintenance Organization Act
Chapter 20 A Section 18B
Senate Bill 418

PPO
Texas Insurance
3.70-3c, Section 3a

HMO
Article 20A.18b

45 days for payment, denial or audit of non-electronic, non-pharmacy clean claims; 30 days for payment, denial or audit of electronic; non-pharmacy clean claims; 21 days from affirmative adjudication for payment of pharmacy claims. Late payment penalties: (1) If claim is paid on or before 45th day after applicable statutory claim payment period (as defined) carrier must pay: contracted rate plus the lesser of 50% of difference between contracted rate and billed charges or $100,000. (2) If claim is paid on or after the 46th day but before 91st day after applicable statutory claim payment period, carrier must pay: the contracted rate plus the lesser of 100% of the difference between contracted and billed charge or $200,000. (3) If claim is paid on or after the 91st day after the applicable statutory claim payment period, the carrier must pay the contracted rate plus the penalty specified in paragraph 2 plus 18% interest on the penalty amount. Texas Department of Insurance

(512) 322-4266

Utah

State Rule 590-89 Unfair Claims Settlement Practices Rule

30 days for claim payment. For the first 90 days that the payment is late: multiply the total amount of the claim by the total number of days that the payment is late by 1%. For a claim payment that is 91 or more days late, add the late fee for the first 90 days and the following sum: the total amount of the claim, the number of days that the response is late beyond the initial  90 days and the rate of  interest established under § 15-1-1. Utah Department of Insurance

(801) 538-3800

Vermont

Title 18 Chapter 221 Section 9418
Payment for Health Services

Claims must be paid in 45 days. Interest penalty is 12% per annum. Vermont Department of Insurance

(802) 828-3301

Virginia

Chapter 34, Title 38.2
Section 38.2-3407.13
Ethics and Fairness in Carrier Business Practice

Clean claims must be paid within 40 days.  Penalty interest rate is the legal rate of interest. Virginia Legislative Services

(804) 786-3591

Washington

R § 284-43-321 (1999)

30 days for clean claims.   Interest penalty is 1% per month. Washington Insurance Commission

(360) 753-7300

West Virginia

33-43-2

30 days for electronic clean claims and 40 days for manual (non-electronic) clean claims.  Interest penalty is 10% per year. West Virginia Division of Insurance

(304) 558-3386

Wisconsin

Insurance Chapter 628 Insurance Marketing
Subchapter III. Marketing Practices 628.46 Timely Payment of Claims

If claims are not paid within 30 days they are subject to a penalty interest rate of 12% per year. Wisconsin Department of Insurance Complaints & Consumer Services

(608) 266-3585

Wyoming

Title 26 Insurance Code
Chapter 15 The Insurance Contract 26-15-124 Claim to be accepted or rejected; attorney's fees

Claims must be paid within 45 days. Interest penalty is 10% per year. Wyoming Department of Insurance

(307) 777-7401