Skip to main content

Introduced House Bill (H)

DIGEST

Medicaid reimbursement of DME. Specifies Medicaid reimbursement rates that are required of the office of the secretary of family and social services (office) and a managed care organization for durable and home medical equipment and supplies, prosthetics, orthotics, and services. Requires the office and a managed care organization to cover the same: (1) health care codes; (2) scope and quantities of certain items; and (3) time frames for submissions of claims and discrepancies; as under the Medicaid program. Specifies that if the office fails to correctly process a clean claim in the specified time requirements, the office may not claim Medicaid reimbursement of DME. Specifies Medicaid reimbursement rates that are required of the office of the secretary of family and social services (office) and a managed care organization for durable and home medical equipment and supplies, prosthetics, orthotics, and services. Requires the office and a managed care organization to cover the same: (1) health care codes; (2) scope and quantities of certain items; and (3) time frames for submissions of claims and discrepancies; as under the Medicaid program. Specifies that if the office fails to correctly process a clean claim in the specified time requirements, the office may not claim that the provider failed to meet the time requirements for submission of the clean claim. Repeals language that specifies that Medicaid law is controlling when Medicaid law conflicts with insurance law. ... View more