I
106TH CONGRESS
2D SESSION
H. R. 3993
To amend title XXVII of the Public Health Service Act, title I of the
Employee Retirement Income Security Act of 1974, the Internal Revenue
Code of 1986, and title XVIII of the Social Security Act to require
that group and individual health insurance coverage, group health plans,
and Medicare+Choice organizations provide prompt payment of claims.
IN THE HOUSE OF REPRESENTATIVES
MARCH 15, 2000
Mrs. MCCARTHY of New York introduced the following bill; which was re-
ferred to the Committee on Commerce, and in addition to the Committees
on Ways and Means, and Education and the Workforce, for a period to
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee
concerned
A BILL
To amend title XXVII of the Public Health Service Act,
title I of the Employee Retirement Income Security Act
of 1974, the Internal Revenue Code of 1986, and title
XVIII of the Social Security Act to require that group
and individual health insurance coverage, group health
plans, 
and 
Medicare+Choice 
organizations 
provide
prompt payment of claims.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Prompt Payment of
Health Benefit Claims Act of 2000’’.
SEC. 2. PROMPT PAYMENT OF HEALTH BENEFIT CLAIMS BY
GROUP HEALTH PLANS AND HEALTH INSUR-
ANCE ISSUERS.
(a) GROUP HEALTH PLANS.—
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENTS.—Subpart 2 of part A of title XXVII of the
Public Health Service Act is amended by adding at
the end the following new section:
‘‘SEC. 2707. STANDARD RELATING TO PROMPT PAYMENT OF
CLAIMS.
‘‘A group health plan, and a health insurance issuer
offering group health insurance coverage, shall—
‘‘(1) pay the claim to a participant or bene-
ficiary, or make a payment to a health care provider,
within 15 business days of the date of the claim or
bill for services rendered (in the case of a claim or
bill transmitted electronically) or within 30 business
days of such date for other claims or bills submitted
in writing; and
‘‘(2) shall accept as a clean claim a claim that
is submitted consistent with the standards adopted
under part C of title XI of the Social Security Act
(as added by section 262 of the Health Insurance
Portability and Accountability Act of 1996).’’.
(2) ERISA AMENDMENTS.—(A) Subpart B of
part 7 of subtitle B of title I of the Employee Re-
tirement Income Security Act of 1974 is amended by
adding at the end the following new section:
‘‘SEC. 714. STANDARD RELATING TO PROMPT PAYMENT OF
CLAIMS.
‘‘A group health plan, and a health insurance issuer
offering group health insurance coverage, shall—
‘‘(1) pay the claim to a participant or bene-
ficiary, or make a payment to a health care provider,
within 15 business days of the date of the claim or
bill for services rendered (in the case of a claim or
bill transmitted electronically) or within 30 business
days of such date for other claims or bills submitted
in writing; and
‘‘(2) shall accept as a clean claim a claim that
is submitted consistent with the standards adopted
under part C of title XI of the Social Security Act
(as added by section 262 of the Health Insurance
Portability and Accountability Act of 1996).’’.
(B) Section 732(a) of such Act (29 U.S.C.
1191a(a)) is amended by striking ‘‘section 711’’ and
inserting ‘‘sections 711 and 714’’.