03/23/2026
Way to go WSLHA advocacy! SB 5845 was just signed into law by Gov. Ferguson. Here are some of the highlights of the new law:
Senate Bill 5845 (ESSB 5845), which focuses on modernizing and strengthening timely payment requirements for health carriers, aiming to improve cash flow for hospitals and providers.
Key details of the legislation for 2026 include:
Clean Claim Definition & Deadline: Beginning January 1, 2027, carriers and plans for public employees must pay or deny "clean claims" within 30 calendar days of receipt.
Notice Requirement: For claims that are not "clean," carriers must send electronic notice within 21 calendar days of receipt, requesting necessary information or explaining the denial.
Interest on Late Payments: Interest on unpaid clean claims will be charged at 1% per month for the first 60 days following non-compliance, increasing to 1.5% per month thereafter.
Claw back Restrictions: Starting January 1, 2028, carriers are restricted from requesting refunds (claw backs) for payments unless done in writing within 12 months of the original payment (or 18 months for coordination of benefits), excluding fraud cases.