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2019 General Assembly: Prompt Payment

Monday, March 11, 2019   (0 Comments)
Posted by: Matthew Nicholas
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2019 General Assembly: Prompt Payment

As the IPTA continues to work the Illinois State Medical Society (ISMS) and the Illinois Health and Hospital Association (IHHA) to address the delays in claims processing by Blue Cross Blue Shield of Illinois subsequent to their contract with Verscend to manage claims, we are following legislation that has been introduced to address delays in payments. 

SB 2057 would require that any bill approved by the State for payment on or after July 1, 2019 must be paid or the payment issued to the payee within 90 days of receipt of a proper bill or invoice. If payment is not issued to the payee within this 90-day period, an interest penalty calculated using the prompt payment interest rate shall be added for each month or fraction thereof after the end of this 90-day period until final payment is made. The State Comptroller would determine the prompt payment interest rate for the fiscal year beginning on that July 1.

HB 2465 would require that all managed care plans shall ensure that all claims and indemnities concerning health care services shall be paid within 30 days after receipt of a claim that has provided specified information on a CMS-1500 Health Insurance Claim Form or a UB-04 (CMS-1450) form. Further, it would require that certain health care providers shall be notified of any known failure of the claim and provide detailed information on how the claim may be satisfied to receive payment within 30 days after receipt and that any undisputed portions of a claim must be reimbursed by the managed care plan within 30 days after receipt. It would grant the Department of Insurance specific authority to issue a cease and desist order, fine, or otherwise penalize managed care plans that violate provisions concerning timely payment for health care services. It also provides that a policy issued or delivered to the Department of Healthcare and Family Services that provides coverage to certain persons is subject to the provisions concerning timely payment for health care services.



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