MCO prompt pay bill advances

KHI News Services reported yesterday that a bill aimed at speeding payments from the state's KanCare contractors to Medicaid service providers was endorsed by the House Health and Human Services Committee.

The measure essentially would write into law some of the payment requirements already included in the state's contracts with the three insurance companies that have run day-to-day operations of the Kansas Medicaid program since Jan. 1, 2013, when the administration of Gov. Sam Brownback moved virtually all the state's Medicaid enrollees into health plans run by three managed care companies.

House Bill 2552, a so-called "prompt pay" bill, had the backing of most of the state's Medicaid provider groups and faced no opposition.

The bill also would let doctors, hospitals and other Medicaid service providers collect 12 percent interest on late payments from the KanCare companies. The three current contractors are Amerigroup, UnitedHealthcare and Sunflower State Health Plan, a subsidiary of Centene.

A similar measure, Senate Bill 317, was introduced in the Senate and heard last week by the chamber's Public Health and Welfare Committee. But no action has yet been taken on it.

The state's contracts with the insurance companies include provisions that require they make timely payment for so-called "clean claims" submitted by Medicaid providers. The insurance companies have reported to state officials that they are meeting the contract standards well enough to qualify for the contract dollars the state has held back as an incentive for prompt payments.

A clean claim is one deemed by the managed care company to have been properly submitted in accordance with its billing procedures.

Providers have complained that the state's contractual requirements for prompt payment have failed to account for the time it can take for a claim to be deemed "clean."

InterHab, the group that represents most of the state's Community Developmental Disability Organizations, pushed to have the 12 percent interest penalty in the bill raised to 18 percent. An amendment that would have done that was offered by Rep. Jim Ward, a Wichita Democrat. But his amendment failed on a voice vote.

Read the complete Kansas Health Institute article HERE.