Colorado Legislative Council Staff

REVISED NO FISCAL IMPACT

(replaces fiscal impact dated February 5, 1999)

Drafting Number:

Prime Sponsor(s):

LLS 99-0435

Rep. Johnson

Sen. Epps

Date:

Bill Status:

Fiscal Analyst:

February 16, 1999

House 2nd Reading

Will Meyer (303-866-4976)

 

TITLE:            CONCERNING REQUIREMENTS FOR THE PROMPT PAYMENT OF HEALTH INSURANCE CLAIMS.



Summary of Assessment


             This bill requires health insurance entities to pay "clean" claims within 30 days after electronic filing of the claim and 45 days after paper filing unless the claim is disputed. The bill defines a "clean" claim as a claim for payment of health care expenses that is submitted to a carrier on the carrier's standard claim form with all required fields completed. The bill requires, absent fraud, all claims be paid within 90 days following submission of the claim. The bill makes any claim not acted upon or paid within the required time periods subject to interest at the rate of 10 percent annually on the total amount ultimately allowed on the claim.


             The bill, as amended in the House Health, Environment, Welfare, and Institutions Committee, clarifies the language in the bill thereby eliminating conflicts with current regulations. The amended bill also changes the effective implementation date to January 1, 2000, so carriers can include the changes in their routine filings. These changes will eliminate the fiscal impact to the Division of Insurance, Department of Regulatory Agencies, identified in the original fiscal note. The bill will not impact any other state agency or unit of local government. Therefore, this bill is assessed as having no fiscal impact.



Departments Contacted


             Regulatory Agencies