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Committee introduces RS 31,796 to ensure Medicaid remains payer of last resort for prior-authorized services
Summary
Jared Larson presented RS 31,796, which the Department of Health and Welfare said is intended to comply with the Consolidated Appropriations Act of 2020 and to ensure Medicaid remains the payer of last resort when services are authorized by Medicaid.
Jared Larson presented RS 31,796, which the department described as necessary to comply with the Consolidated Appropriations Act of 2020 and to ensure Medicaid remains the payer of last resort.
Larson said the federal law requires state medical-assistance programs to have laws that bar third-party payers from refusing payment for an item or service solely because the item or service did not receive prior authorization, when Medicaid is authorized to cover it. In plain terms, Larson explained, the bill aims to prevent a scenario in which a private insurer denies payment for lack of prior authorization when Medicaid would cover the service and has authorized payment.
Representative Healy moved to introduce RS 31,796. The committee chair called the question; members said "aye," and the chair announced, "RS 31,796 is introduced." Larson said the department would present additional detail if the bill is printed and scheduled for a bill hearing.
