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DIGEST OF SB311 (Updated April 12, 2001 11:30 AM - DI 84)
Prompt payment of claims. Defines a "clean claim" for purposes of provider reimbursement under state employee health benefit plans, accident and sickness insurance policies, and health maintenance organization contracts. Provides a procedure for determining whether a state employee health benefit plan, an accident and sickness insurer, or a health maintenance organization shall pay, deny, or suspend claims for payment submitted by providers. Requires a state employee health benefit plan, an accident and sickness insurer, or a health maintenance organization to make this determination and to notify the provider of deficiencies or pay a clean claim within 30 days after the claim is filed electronically or within 45 days after the claim is filed on paper. Requires a state employee health benefit plan, an accident and sickness insurer, or a health maintenance organization to pay interest to a provider who submits a clean claim that is paid later than the applicable deadline. Specifies the period during which interest accrues and provides the interest rate that applies. Allows the insurance commissioner to impose a civil penalty upon an insurer or a health maintenance organization for failure to comply with requirements for payment of clean claims.
