Medicaid Third-Party Liability Payments

The bill requires third-party payers to reimburse the department of health care policy and financing (state department) for health-care items and services rendered to a medicaid member regardless of whether prior authorization was obtained.

The bill requires third-party payers to respond to the state department's inquiry regarding a claim for payment no later than 60 days after receiving the state department's inquiry. The third party must respond either by paying the claim or issuing a written denial of the claim to the state department.
(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)