Missouri lawmakers have advanced two bills aimed at speeding insurance payments to hospitals and health care providers.
The House and Senate each voted overwhelmingly to approve their own versions of legislation setting up a time schedule for medical providers to provide information on claims and for insurers to pay them. Both versions would create financial penalties for insurance companies that fail to pay health care claims within about 45 days.
The legislation also would set a definition for claims that contain all the necessary information and prohibits insurance companies from suspending payment on claims.
Sponsoring Sen. Jim Lembke, R-St. Louis, said health care providers now call suspended claims “the black hole.”
Health care providers contend some insurance companies have taken too long to pay the costs for claims. Hospitals and medical clinics say the lag can create financial difficulties and makes the process unnecessarily complicated.
Insurers say they need to ensure claims are valid, properly submitted and contain all the required information.
Rep. Tim Jones, who sponsored the House version, said the proposed changes would help everyone.
“There will be a lot more incentive for insurers to pay the claims, pay them efficiently and pay them timely,” said Jones, R-Eureka. “And there will be an incentive for the health care providers to provide all the information that is necessary.”
A report released last month by the state Department of Insurance, Financial Institutions & Professional Registration found more than $500 million in outstanding claims at 69 Missouri hospitals. More than a quarter of those claims had been unpaid for at least 90 days.
The study found significant differences in unpaid claims across the state, with 11 percent of claims remaining unpaid after 90 days in northwest Missouri but 70 percent still unpaid after 90 days in the northeastern part of the state.
Democratic Gov. Jay Nixon, who has called for changes in the handling of health insurance claims, praised lawmakers. The Senate approved its version 34-0 and the House endorsed its bill 157-0.
“This legislation will help make sure that Missouri’s health care providers, hospitals and rural doctors will be paid more quickly for the services they provide to their patients,” Nixon said.
Associated Press writer David A. Lieb contributed to this report.
Insurance payments measures are SB636 and HB1498
On the Net: www.moga.mo.gov
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