Relates to payment of claims submitted by healthcare agencies.
Summary
Bill S03365 amends the public health law to establish specific requirements for the payment of claims submitted by healthcare agencies, including licensed home care services agencies and certified home health agencies. The bill mandates that payors must pay clean claims within specified timeframes: thirty days for electronic submissions and forty-five days for paper submissions. It also requires payors to notify providers of any defects or disputes within fifteen days of receipt of a claim, ensuring that no further disputes can be raised unless based on new information.
Impact
The bill impacts state laws by enforcing stricter timelines and requirements for the payment of claims from healthcare agencies, thereby aiming to improve cash flow and operational stability for these agencies. It introduces penalties for payors who fail to comply with the established standards, which could lead to increased accountability and prompt payments in the healthcare sector.
Sentiment
The general sentiment around Bill S03365 appears to be supportive among healthcare providers, as it addresses long-standing issues related to delayed payments and claim disputes. However, there may be concerns from payors regarding the potential increase in administrative burdens and financial liabilities due to the new requirements.
Contention
Notable points of contention may arise from the payors, who might argue that the new timelines and penalties could lead to increased operational costs and challenges in managing claims processing. Healthcare agencies, on the other hand, are likely to advocate for the bill as a necessary measure to ensure timely payments and reduce financial strain.
To Prohibit Healthcare Insurers From Exercising Recoupment For Payment Of Healthcare Services More Than One Year After The Payment For Healthcare Services Was Made.