31 Oct 2017
- By Cherrie Anne E. Villahermosa – [email protected] – Variety News Staff
SENATOR Sixto Igisomar has introduced a bill that would mandate the prompt payment of healthcare services performed in the CNMI, and authorize healthcare service providers to impose penalties on late payments received for clean claims.
Senate Bill 20-78 also proposes to set uniform standards for processing electronic claims.
According to Igisomar, prompt payment of healthcare services is crucial to the sustainability of healthcare organizations.
He said healthcare providers in the CNMI sometimes wait several months to get reimbursed for a complete clean claim. In some cases, they don’t get paid at all.
He said payment delays cause an undue burden on healthcare providers and organizations as they spend time and resources to collect.
The bill proposes to add a new Chapter 7 to the Commonwealth Code that will be known as the Health Claims Uniformity and Prompt Payment Act.
Some of its key provisions:
“Section 103. Prompt Payment. (a) within 180 calendar days of the effective date of this Act, for covered services rendered to its members, a health insurance issuer shall reimburse any person entitled to reimbursement under the health plan within 40 calendar days after the date of receipt on a clean claim.
“(b) If a health insurance issuer fails to comply with subsection (a) of this section, the health insurance issuer shall pay interest beginning on the 41st calendar day after the receipt of the claim if the date of payment is not within 40 calendar days. A formal claim by the person filing the original claim shall not be required.
“(c) For electronic claims, the interest payable shall be at a monthly rate from the receipt of claim of:
“(1) One and one-half percent from the 41st calendar day through the 60th calendar day;
“(2) Two percent from the 61st day through the 120th calendar day and,
“(3) Two-and-one-half (2.5) percent after the 120th calendar day.”
Source: Marianas Variety : http://www.mvariety.com/cnmi/cnmi-news/local/99700-bill-aims-to-ensure-prompt-payment-of-healthcare-bills