Bill Status of SB3114

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SB3114 - 104th General Assembly

TRANSPARENCY IN DOWNCODING ACT
Last Action
3/12/2026 - Senate: Placed on Calendar Order of 3rd Reading March 24, 2026
Statutes Amended In Order of Appearance
New Act
Synopsis As Introduced
Creates the Transparency in Downcoding Act. Provides that the Act applies to certain policies of health insurance amended, delivered, issued, or renewed on or after the effective date of the Act, except for employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers' Compensation Act or the Workers' Occupational Diseases Act. Prohibits a health insurance issuer from using an automated process, system, or tool to downcode a claim; from downcoding a claim based solely on the reported diagnosis codes; and from using downcoding practices in a targeted or discriminatory manner against physicians who routinely treat patients with complex or chronic conditions. Requires downcoding decisions to be made by a physician licensed to practice medicine in all its branches in any United States jurisdiction and of the same or similar specialty as a physician who typically manages the medical condition or disease. Sets forth provisions concerning notification requirements for downcoded claims; the appeal process for downcoded claims; enforcement by the Department of Insurance; and penalties. Provides that any pattern or practice of discriminatory downcoding identified by the Director of Insurance or another regulatory authority shall be subject to enforcement actions, including fines, restitution, or suspension of the health insurance issuer's license in this State. Effective immediately.
Actions
Date Chamber Action
2/02/2026 Senate Filed with Secretary by Sen. David Koehler
2/02/2026 Senate First Reading
2/02/2026 Senate Referred to Assignments
2/10/2026 Senate Assigned to Insurance
2/17/2026 Senate Added as Chief Co-Sponsor Sen. Julie A. Morrison
2/17/2026 Senate Added as Co-Sponsor Sen. Laura Fine
2/17/2026 Senate Postponed - Insurance
2/18/2026 Senate Added as Co-Sponsor Sen. Andrew S. Chesney
2/19/2026 Senate Added as Co-Sponsor Sen. Christopher Belt
2/19/2026 Senate Added as Co-Sponsor Sen. Graciela Guzmán
2/24/2026 Senate Added as Co-Sponsor Sen. Paul Faraci
2/24/2026 Senate Added as Co-Sponsor Sen. Suzy Glowiak Hilton
2/25/2026 Senate Added as Co-Sponsor Sen. Linda Holmes
2/25/2026 Senate Added as Co-Sponsor Sen. Ram Villivalam
2/26/2026 Senate Added as Co-Sponsor Sen. Mike Porfirio
2/26/2026 Senate Added as Co-Sponsor Sen. Meg Loughran Cappel
2/26/2026 Senate Added as Chief Co-Sponsor Sen. Cristina Castro
2/27/2026 Senate Added as Co-Sponsor Sen. Doris Turner
3/03/2026 Senate Added as Chief Co-Sponsor Sen. Robert Peters
3/03/2026 Senate Added as Co-Sponsor Sen. Sally J. Turner
3/03/2026 Senate Postponed - Insurance
3/04/2026 Senate Added as Co-Sponsor Sen. Sue Rezin
3/05/2026 Senate Added as Co-Sponsor Sen. Napoleon Harris, III
3/11/2026 Senate Do Pass as Amended Insurance; 010-000-000
3/11/2026 Senate Placed on Calendar Order of 2nd Reading March 12, 2026
3/12/2026 Senate Second Reading
3/12/2026 Senate Placed on Calendar Order of 3rd Reading March 24, 2026
3/23/2026 Senate Added as Co-Sponsor Sen. Rachel Ventura
3/26/2026 Senate Senate Floor Amendment No. 1 Filed with Secretary by Sen. David Koehler
3/26/2026 Senate Senate Floor Amendment No. 1 Referred to Assignments
3/26/2026 Senate Added as Co-Sponsor Sen. Elgie R. Sims, Jr.
4/09/2026 Senate Added as Co-Sponsor Sen. Lakesia Collins