HB 713, HCA 1 -- HEALTH INSURANCE

SPONSOR:  Luetkenhaus

COMMITTEE ACTION:  Voted "do pass" by the Committee on Insurance
by a vote of 16 to 0.

This bill makes several changes to the law governing health
insurance.  The bill:

(1)  Requires health care professionals to use a universal form
when filing a "clean claim" with a health insurance carrier;

(2)  Defines "clean claim" as one that has no defect or
impropriety that would prevent timely payment;

(3)  Requires health insurance carriers to allow
nonparticipating health care professionals to file claims up to
one year from the date of service;

(4)  Requires health insurance carriers to allow participating
health care professionals to file claims up to 6 months from the
date of service;

(5)  Prohibits refunds or offsets against a claim more than one
year after a carrier pays a claim;

(6)  Requires carriers to confirm the receipt of an
electronically filed claim within 24 hours;

(7)  Requires all claims for reimbursement for health care made
after January 1, 2003, to be filed in electronic format
consistent with federal standards; and

(8)  Requires the Director of the Department of Insurance to
appoint a task force, consisting of health care professionals
and insurance carriers, to develop industry standards for
electronic claim processing.

HCA 1 -- Clarifies that the bill does not affect limited benefit
health insurance policies.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of More
Than $40,000 in FY 2002, FY 2003, and FY 2004.

PROPONENTS:  Supporters say that filing electronically whenever
possible will increase the speed and efficiency of the claims
process.  Requiring universal forms and compliance with federal
standards for shared electronic data will benefit both the
recipients of health care and the health care industry.

Testifying for the bill were Representative Luetkenhaus; Golden
Rule Insurance Company; United Health Care of the Midwest;
Missouri Association of Health Plans; Blue Cross/Blue Shield;
Health Insurance Association of America; and Associated
Industries of Missouri.

OPPONENTS:  There was no opposition voiced to the committee.

Richard Smreker, Senior Legislative Analyst

Missouri House of Representatives
Last Updated November 26, 2001 at 11:45 am