Senate committee advances prompt-pay bill amid questions over $14 million fiscal note

Senators advanced Senate Bill 465 on April 22, a measure from Senator McMath designed to shorten insurer payment windows and speed reimbursements to health-care providers. The committee voted to report the bill favorably with technical amendments.

Senator McMath introduced the bill as an update to Louisiana's prompt-pay laws, saying the statutes have not kept pace with processing advances and the integration of new technologies. "Non-electronic clean claims go from 45 days to 30 calendar days," McMath said, and prior-authorized claims would move to shorter deadlines for adjudication. McMath said the governor's office supports the effort and that UnitedHealthcare's recent national changes show the issue is already moving in this direction.

Several members pressed McMath and fiscal staff about a fiscal note that appeared late and estimated a $14,000,000 impact. Senator Bass asked whether the Office of Group Benefits (OGB), Blue Cross Blue Shield or another third party had provided the data that produced the fiscal note. "That seems to be a pretty rushed fiscal note," Bass said. "Is there a process with which you go to somebody other than where there could be a perceived vested interest?"

Randy Davis, Assistant Commissioner with the Division of Administration, acknowledged the fiscal note was prepared quickly and that the division relied on information from the OGB's third-party administrator (TPA). "The intent is to have some further discussions with Blue Cross Blue Shield to talk about revising the fiscal note," Davis said. "We're committed to working to see if we can resolve some of the issues with the fiscal note."

David Laverne of Blue Cross Blue Shield Louisiana told the committee he had spoken with McMath about amendment language and suggested reinserting language that would preserve carve-outs for "suspected fraud, waste, or abuse." Laverne said he did not prepare the fiscal note and was not aware of all the calculations, but he flagged the deletion of long-standing statutory language as a likely driver of the cost estimate.

Committee members repeatedly raised concern about the timing and sourcing of fiscal notes. Senator Myers and others asked for a resolution or rule change to require independent verification when data for a fiscal note comes from parties with a potential financial interest. McMath expressed support for pursuing that change outside the scope of the bill.

After debate and adoption of technical amendments, Senator Myers moved to report SB 465 with amendments; the committee approved the motion. The Division of Administration said it will work with Blue Cross and the Governor's Office to review and, if necessary, revise the fiscal estimate before the bill moves further in the process.

The committee noted multiple provider groups submitted support cards but did not request to speak. The next procedural steps are the legislative calendar and further fiscal review; the committee did not change the bill's statutory goals during the session.

Ending: The committee reported SB 465 favorably with amendments; staff and the Division of Administration said they will revisit the fiscal note and discuss possible guardrails for verification of third-party fiscal inputs.