(SB 65)
Coordination of benefits for medical assistance
between the state and insurers.
Section
1.
That
§
58-12-23
be amended to read as follows:
58-12-23.
Notwithstanding any
other
provision of a
health benefit plan, health insurance
policy,
plan, contract, or certificate, an insurer shall recognize that an application for medical assistance
or acceptance of medical assistance, paid by the Department of Social Services operates as a
release of any information kept by the insurer
and readily available,
that would facilitate efficient
coordination of benefits between the department and the insurer, which may include:
Section
2.
That
§
58-12-24
be amended to read as follows:
58-12-24.
Notwithstanding any
other
provision of a
health benefit plan, health insurance
policy,
plan, contract, or certificate,
that is issued, entered into, or renewed after July 1, 2005,
no insurer
may refuse to reimburse the Department of Social Services
because of the manner, form, or date
of a claim for reimbursement, if within one year after the date the claim has been paid by medicaid,
for which reimbursement is sought, the department provides the insurer evidence of the insurer's
liability
for medical assistance paid by the department on the basis of the date of submission of the
claim, the type or format of the claim form, or a failure to present proper documentation at the
point-of-sale for which reimbursement is sought, if the claim is submitted within three years from
the date the item or service was furnished and any action by the department to enforce its rights
with respect to such claim is commenced within six years of the department's submission of such
claim
.
Section
3.
That
§
58-12-26
be amended to read as follows:
58-12-26.
For the purposes of §§ 58-12-22 to 58-12-29, inclusive, the term, insurer, means: