46th legislature - STATE OF NEW MEXICO - first session, 2003

RELATING TO MEDICAID; REQUIRING MEDICAID PROVIDERS TO BE PAID INTEREST ON CLAIMS NOT PAID TIMELY; ENACTING A SECTION OF THE NMSA 1978.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

Section 1. A new section of the Medicaid Provider Act is enacted to read:

"[NEW MATERIAL] INTEREST ON CLEAN CLAIMS--DEFINITION.--

A. Interest shall be paid to a medicaid provider on a clean claim if payment is not made within thirty calendar days of the claim's submission. Interest shall be paid on a per claim basis at the time of payment. Interest shall not be paid on a claim:

(1) that requires external investigation or development by the payer or claim processing entity;

(2) for which no payment is due; or

(3) that is denied in its entirety.

B. Interest shall be paid at the federal rate established by the secretary of the treasury pursuant to 31 USCA 3902 as follows:

(payment amount x federal rate x calendar days over thirty)/365.

C. As used in this section, a "clean claim" means a claim that contains all required data elements without the need for additional information external to the payer or processor's operation."

Section 2. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2003.