Medicaid Third-Party Liability Payments

The act 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 act requires third-party payers to respond to an inquiry from the state department 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: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to this bill as enacted.)