HB 2057 -- Payments from Third-Party Payers to the MO HealthNet
Division

Sponsor:  Stream

This bill changes the laws regarding the authority of the MO
HealthNet Division within the Department of Social Services to
collect payments from third-party payers.  In its main
provisions, the bill:

(1)  Requires health benefit plans, third-party administrators,
administrative service organizations, and pharmacy benefits
managers to process and pay properly submitted medical assistance
or MO HealthNet subrogation claims:

(a)  For a period of three years from the date of services by an
entity.  The entity cannot deny a claim based on the type or
format of the claim form, failure to present proper documentation
of coverage at the point of sale, or failure to obtain prior
authorization; and

(b)  If the state enforces its right to a claim within six years
of the submission of the claim; and

(2)  Allows computerized records of the division, if certified by
the division director or his designee, to be considered prima
facie evidence of proof of moneys expended and the amount of the
debt due the state.

Missouri House of Representatives
95th General Assembly, 2nd Regular Session
Last Updated September 14, 2010 at 3:12 pm