DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of the
legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law
or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 326 Original 2020 Regular Session Echols
Abstract: Specifies data and other information related to processing of healthcare provider claims
by Medicaid managed care organizations to be included in the quarterly Healthy Louisiana
Claims Report.
Present law requires the La. Department of Health (LDH) to produce and submit to the Joint
Legislative Committee on the Budget and the House and Senate committees on health and welfare
a quarterly report entitled the "Healthy Louisiana Claims Report". Specifies the data on healthcare
provider claims submitted to Medicaid managed care organizations (MCOs) to be included in the
report.
Proposed law retains present law and adds thereto a requirement that the report feature data on
timeliness of claims payments by each MCO which, at minimum, shall include an average and a
median days-to-payment metric for all claims reflecting the number of calendar days elapsed from
the date of claim submission by the provider to the date of claim payment by the MCO. Provides
that if a claim for payment is denied in whole or in part and the provider resubmits the claim and the
MCO ultimately pays all or part of the claim, then the days-to-payment metrics for that claim shall
be based upon the date of submission of the original claim.
Present law provides that the report shall feature a narrative which includes, at minimum, the action
steps which LDH plans to take in order to address certain issues in Medicaid managed care.
Proposed law retains present law and adds timeliness of claims payments by MCOs as an issue to
be addressed in the report.
(Adds R.S. 46:460.91(C)(5) and (F))