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F I S C A L I M P A C T R E P O R T



SPONSOR: Ingle DATE TYPED: 5/11/99 HB
SHORT TITLE: Payment of Interest on "Clean Claims" SB 49
ANALYST: Esquibel


APPROPRIATION



Appropriation Contained
Estimated Additional Impact
Recurring

or Non-Rec

Fund

Affected

FY99 FY2000 FY99 FY2000
N/A



(Parenthesis ( ) Indicate Expenditure Decreases)



Relates to SB4



SOURCES OF INFORMATION



LFC Files



SUMMARY



Synopsis of Bill



The bill requires that claims submitted by participating providers to health maintenance organizations (HMO) shall have interest paid to the provider at the rate of one and one-half percent a month, compounded monthly on the amount of the claim not paid within 30 days or on the portion of the claim not under dispute. A HMO shall notify a provider in writing if there is a problem with payment of a claim.



The Insurance Division of the Public Regulation Commission shall promulgate rules requiring HMOs to promptly notify both governmental and private providers.



CONFLICT/DUPLICATION/COMPANIONSHIP/RELATIONSHIP



SB49 almost duplicates SB4, except that SB49 would not require payment of interest on the portion of a claim submitted to the HMO that is not in dispute and does not require additional information for adjudication if the HMO fails to pay the undisputed or substantiated portion of the claim within 30 days; and SB49 does not apply to claims that are not submitted electronically.



RAE/njw