PlainBillCongress, translated.Legislation. Context. Public interest.Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S2912-2914)
Congressional Research Service
Version 00 · Introduced in Senate · Apr 5, 2006
Prompt Payment of Health Benefits Claims Act of 2006 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) and the Public Health Service Act to require group health plans and issuers of group health insurance to: (1) acknowledge receipt of claims within ten days; (2) notify claimants, within ten days, of any deficiency in submitted claims and of additional information necessary to correct the deficiency; (3) pay clean and uncontested claims and any uncontested portions of claims within 14 days if submitted electronically or within 30 days otherwise; and (4) pay escalating, monthly interest for failing to pay claims within such periods.
Provides that claims are deemed clean ten days after receipt if no notice of any deficiency is given to the claimant. Prohibits retaliation by the plan or issuer for claimants exercising rights under this Act. Requires the Secretary of Health and Human Services to impose fines for willful and knowing violations of this Act or patterns of repeated violations of this Act.
Amends the Public Health Service Act to apply the provisions of this Act to plans issued in the individual market.
Showing the opening paragraphs of the official summary.
Amends the Social Security Act to apply these requirements to Medicare prescription drug plans, Medicare Advantage prescription drug plans, and Medicaid managed care plans.
Allows state laws that provide equal or more stringent requirements, standards, or implementation specifications than imposed under this Act.
People & committees
Sen. Menendez, Robert [D-NJ] · D–NJ
Legislative record
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Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S2912-2914)
Sponsor introductory remarks on measure. (CR S2911-2912)
Introduced in Senate
Primary sources
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Source last updated: Aug 15, 2025. Consult Congress.gov for the current record.
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