S.F. 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 -1- LSB 5789XS (3) 89 pf/rh 1/ 1