Medicaid Third-Party Payor Conditions
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Bill Summary - 24LSO-0014 Bill No.: HB0025 Effective: 7/1/2024 LSO No.: 24LSO-0014 Enrolled Act No.: HEA No. 0019 Chapter No.: 24 Prime Sponsor: Joint Labor, Health & Social Services Interim Committee Catch Title: Medicaid-third party payor conditions. Has Report: No Subject: Wyoming Medical Assistance and Services Act. Summary/Major Elements: Current law requires all health insurers (and other specified entities and persons) that are legally responsible for payment of a claim for a health care item or service to agree, as a condition of doing business in the state of Wyoming, to comply with certain requirements. This act amends two (2) of the requirements to clarify that health insurers (and other specified entities and persons) must: Respond within sixty (60) days to any inquiry by the state regarding a claim for payment for any health care item or service that is submitted not later than three (3) years after the date of the provision of the health care item or service; and Agree not to deny a claim submitted by the state solely on the basis of a failure to obtain required prior authorization if the state meets specified conditions regarding the claim. The above summary is not an official publication of the Wyoming Legislature and is not an official statement of legislative intent. While the Legislative Service Office endeavored to provide accurate information in this summary, it should not be relied upon as a comprehensive abstract of the bill.
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Last checked Aug 5, 6:34 AM
Why they voted this way
The speaker explains that the bill is a statutory cleanup required by federal law changes, specifically adding a 60-day deadline for written responses to Medicaid claim inquiries to ensure payments are recovered.
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