The bill requires third-party payers to reimburse the department of
health care policy and financing (state department) for health-care items and services rendered to a medicaid member regardless of whether prior authorization was obtained.
The bill requires third-party payers to respond to the state
department's inquiry regarding a claim for payment no later than 60 days after receiving the state department's inquiry. The third party must respond either by paying the claim or issuing a written denial of the claim to the state department.
