HB 25-1033

House Bill 25-1033, which has been signed into law, requires insurance companies and other third-party payers to reimburse the state for healthcare costs paid by Medicaid if those costs should have been covered by another insurer. The bill also mandates that these third parties respond within 60 days when the state asks about a claim for payment, either by paying it or denying it in writing. This impacts insurance companies and affects how Medicaid recipients' medical bills are handled, ensuring other insurers cover their share first.

Official Summary

The act requires third-party payers to reimburse the department of health care policy and financing (state department) for health-care items and services rendered to a medicaid member regardless of whether prior authorization was obtained. The act requires third-party payers to respond to an inquiry from the state department regarding a claim for payment no later than 60 days after receiving the state department's inquiry. The third party must respond either by paying the claim or issuing a written denial of the claim to the state department. (Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.) (Note: This summary applies to this bill as enacted.)

Related Legislation

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