Grisamore Joins Republican House Colleagues & Governor for Signing of Health Insurance Prompt Pay Bill into Law
Posted by GSDispatch Editor in by Jeff Grisamore, GSD Online, Health
JEFFERSON CITY, Mo. – State Representative Jeff Grisamore, R-Lee’s Summit/Greenwood, joined two other House Republicans at the Capitol today for the signing of House Bill 1498—the Missouri Prompt Pay Act—into law by Governor Jay Nixon. Grisamore, one of five Republican co-sponsors of HB 1498, was joined in the governor’s office for the bill signing by Rep Tim Jones, R-Eureka, and Rep. Wayne Cooper, R-Camdenton, along with Sen. Jim Lembke, R-St. Louis, the Senate handler.
Along with Grisamore, Lee’s Summit legislator, Sen. Matt Bartle, R-Lee’s Summit, was also instrumental in the passage of this bill. During their remarks, Jones and Lembke both commended Bartle for facilitating the coordination of the various stakeholders in this legislation. As only the second bill Governor Nixon has signed into law this year with the end of session three weeks away, HB 1498 requires more rapid payment of health insurance claims by carriers to providers on behalf of patients.
The new Missouri Prompt Pay Act requires health insurers to pay claims within 45 processing days. It also specifies that a claim for which a carrier has not communicated a specific reason for the denial of payment cannot be considered denied. The act creates a penalty equal to one percent of the total claim amount per day on unpaid claims if a carrier has not paid a claimant within 45 processing days of receiving the claim.
The new law also requires carriers to notify the health care provider electronically or by fax within 10 processing days, instead of the current 15 days. Upon receiving the requested additional information from the provider to pay the claim, carriers must either pay or deny the claim and specify the reason for doing so, or make a final request for additional information.
If the provider submits the additional information, the carrier must pay or deny the claim within five processing days, instead of the current 15 days, of receiving the additional information. The new law also prohibits the suspension of claims, which can delay payment of claims indefinitely.
The Missouri Prompt Pay Act was catalyzed by a 2009 study conducted by the Missouri Department of Insurance that showed 26 percent of claims at 69 Missouri hospitals were past due by 90 days or more. The study also showed that in the second quarter of 2009, hospitals reported $153 million in claims unpaid after 90 days.
Grisamore, who serves on the House Appropriations Committee for Health, Mental Health and Social Services, said, “This important new law will provide additional consumer protections to Missourians who receive health care services.”
“After passing House Bill 818, three years ago, the Missouri Health Insurance Portability and Accountability Act of 2007, which I co-sponsored as well, we are very thankful to have passed into law another piece of meaningful health care reform legislation in Missouri,” Grisamore added.
The bill will go into effect January 1, 2011.
