The bill prohibits a prepaid inpatient health plan from: •
Requiring prior authorization for outpatient psychotherapy
services;
•
Recovering provider payments if a recipient was initially determined to be eligible for medical benefits; and
•
Retroactively recovering provider payments after 12 months from the date a claim was paid, except in certain circumstances.
If a prepaid inpatient health plan retroactively recovers a provider
payment that is equal to or greater than $1,000, the bill requires the prepaid inpatient health plan to work with the provider to develop a payment plan if the provider requests a payment plan.
