Bill Text: IA SF2065 | 2021-2022 | 89th General Assembly | Introduced
Bill Title: A bill for an act relating to claims incorrectly denied or underpaid by Medicaid managed care organizations.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2022-01-24 - Subcommittee: Garrett, Edler, and Ragan. S.J. 136. [SF2065 Detail]
Download: Iowa-2021-SF2065-Introduced.html
Senate
File
2065
-
Introduced
SENATE
FILE
2065
BY
RAGAN
and
MATHIS
A
BILL
FOR
An
Act
relating
to
claims
incorrectly
denied
or
underpaid
by
1
Medicaid
managed
care
organizations.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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2065
Section
1.
MEDICAID
PROVIDER
INCORRECTLY
DENIED
OR
1
UNDERPAID
CLAIMS
——
INTEREST.
The
department
of
human
services
2
shall
contractually
require
that
a
Medicaid
managed
care
3
organization
that
fails
to
pay
a
claim
submitted
by
a
provider
4
that
is
ultimately
found
to
be
incorrectly
denied
or
underpaid
5
through
an
appeals
process
or
audit
shall
pay
a
Medicaid
6
provider
claimant,
in
addition
to
the
amount
owed,
an
interest
7
payment
based
on
the
amount
owed
as
follows:
8
1.
If
paid
within
forty-five
days
of
the
date
the
claim
was
9
submitted,
interest
at
the
rate
of
twelve
percent
per
annum.
10
2.
If
paid
between
forty-six
and
sixty
days
of
the
date
the
11
claim
was
submitted,
interest
at
the
rate
of
eighteen
percent
12
per
annum.
13
3.
If
paid
sixty-one
or
more
days
from
the
date
the
claim
14
was
submitted,
interest
at
the
rate
of
twenty-one
percent
per
15
annum.
16
EXPLANATION
17
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
18
the
explanation’s
substance
by
the
members
of
the
general
assembly.
19
This
bill
requires
the
department
of
human
resources
to
20
contractually
require
that
if
a
claim
submitted
by
a
Medicaid
21
provider
is
ultimately
found
to
be
incorrectly
denied
or
22
underpaid
through
an
appeals
process
or
audit,
a
managed
care
23
organization
(MCO)
shall
pay
a
Medicaid
provider
claimant,
in
24
addition
to
the
amount
owed,
an
interest
payment
based
on
the
25
amount
owed
and
the
number
of
days
that
have
elapsed
since
the
26
claim
was
submitted
ranging
from
a
rate
of
12
to
21
percent
per
27
annum.
28
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