26B-2-209. Failure to follow certain health care claims practices — Penalties.
| (1) |
The department may assess a fine of up to $500 per violation against a health care facility that violates Section 31A-26-313. |
Terms Used In Utah Code 26B-2-209
- Credit bureau: An agency that collects individual credit information and sells it for a fee to creditors so they can make a decision on granting loans. Typical clients include banks, mortgage lenders, credit card companies, and other financing companies. (Also commonly referred to as consumer-reporting agency or credit-reporting agency.) Source: OCC
- Health care facility: means general acute hospitals, specialty hospitals, home health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing centers, ambulatory surgical facilities, small health care facilities, abortion clinics, a clinic that meets the definition of hospital under Section 76-7-301 or 76-71-201, facilities owned or operated by health maintenance organizations, end stage renal disease facilities, and any other health care facility which the committee designates by rule. See Utah Code 26B-2-201
| (2) |
The department shall waive the fine described in Subsection (1) if:
| (a) |
the health care facility demonstrates to the department that the health care facility mitigated and reversed any damage to the insured caused by the health care facility or third party’s violation; or |
| (b) |
the insured does not pay the full amount due on the bill that is the subject of the violation, including any interest, fees, costs, and expenses, within 120 days after the day on which the health care facility or third party makes a report to a credit bureau or takes an action in violation of Section 31A-26-313. |
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Renumbered and Amended by Chapter 305, 2023 General Session
