Pennsylvania prompt pay law: deadlines, interest, and how to use it

Yes. Pennsylvania's prompt-pay provisions (Act 68, 40 P.S. §991.2166, and related insurance law) require licensed insurers and managed-care plans to pay clean claims within a set window or owe interest.

The key rules

• Clean claims are generally due within 45 days of receipt
• Late payment accrues statutory interest, commonly cited around 10% per annum, from the due date
• The rule covers clean claims that aren't legitimately contested or pending needed information
• Applies to state-regulated commercial plans and managed-care organizations

How to use it

• Fix the receipt date, then measure the 45-day window to identify late clean claims
• Calculate interest at the statutory rate from the due date and request it in writing
• Cite Act 68 / the applicable insurance law section when raising it with the payer
• Escalate unresolved late-payment patterns to the Pennsylvania Insurance Department

Confirm the current interest rate and any distinctions between insurer and managed-care claims. Prompt-pay rules reach state-regulated (fully insured) commercial plans, not ERISA self-funded employer plans, which are a large share of commercial volume. Medicare and Medicaid pay under their own separate prompt-payment rules. Confirm the current payment window, interest rate, and penalty against the statute or your state insurance department before citing a figure in an appeal, since rates are reset by legislation and by annual DOI rate-setting.

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