265.962 Enhancements to the Prompt Payment Law
MSSNY will seek enhancements to the current Prompt Payment Law stipulating that when additional information has been requested and received from a physician and/or patient, that the health care plan requesting the information be required to process and pay that claim within a specified (reasonable) period of time, or be subject to severe monetary penalties.
Once an HMO places a claim in a “pended” category (awaiting additional information), the HMO should be required to continue written communications with the physician and/or patient, on a periodic basis (i.e., every 30, 60 or 90 days) until the requested documentation has been received. (HOD 2000-71; Reaffirmed HOD 2014; Reaffirmed HOD 2021-56)
