Bill Text: PA HB1287 | 2011-2012 | Regular Session | Introduced

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Bill Title: Providing for prompt payment of claims.

Spectrum: Moderate Partisan Bill (Republican 13-4)

Status: (Introduced - Dead) 2011-04-05 - Referred to HEALTH [HB1287 Detail]

Download: Pennsylvania-2011-HB1287-Introduced.html

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PRINTER'S NO. 1423
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1287 Session of2011
INTRODUCED BY BENNINGHOFF, CREIGHTON, FLECK, GABLER, GINGRICH, GROVE, KAUFFMAN, LONGIETTI, MAHONEY, MILLER, READSHAW, REICHLEY, VULAKOVICH AND YOUNGBLOOD, APRIL 5, 2011
REFERRED TO COMMITTEE ON HEALTH, APRIL 5, 2011
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," providing for prompt
payment of claims.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of June 13, 1967 (P.L.31, No.21), known
as the Public Welfare Code, is amended by adding a section to
read:
Section 443.11. Prompt Payment of Claims.--(a) The
department shall pay a clean claim submitted by a participating
medical assistance provider within forty-five days of receipt of
the clean claim.
(b) If the department fails to remit the payment as provided
under subsection (a), interest at ten percent per annum shall be
added to the amount owed on the clean claim. Interest shall be
calculated beginning the day after the required payment date and
ending on the date the claim is paid. The department shall not
be required to pay any interest calculated to be less than two
dollars ($2).
(c) As used in this section, the term "clean claim" means a
claim for payment for a health care service which has no defect
or impropriety. A defect or impropriety shall include lack of
required substantiating documentation or a particular
circumstance requiring special treatment which prevents timely
payment from being made on the claim. The term shall not include
a claim from a participating medical assistance provider who is
under investigation for fraud or abuse regarding that claim.
Section 2. This act shall take effect in 60 days.
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