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2008 SESSION

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SB 403 Pharmacy benefits; claims and payments submitted electronically.

Introduced by: Phillip P. Puckett | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED SENATE:

Ethics and fairness in carrier business practices; payment of claims for pharmacy benefits. Requires contracts between a health insurance carrier and its administrator of pharmacy benefits to make payments electronically to the participating provider or its designee if the contract with the provider requires claims to be submitted electronically. The measure applies to contracts entered into, amended, extended or renewed on or after January 1, 2009.

SUMMARY AS INTRODUCED:

Ethics and fairness in carrier business practices; payment of claims for pharmacy benefits.  Adds a provision to the minimum fair business standards that are required to be included in contracts between health insurance carriers and health care providers. The new provision requires a carrier's administrator of pharmacy benefits to make payments electronically to the participating provider or its designee if the contract with the provider requires claims to be submitted electronically. The requirement applies to clean claims submitted electronically in the form required by the payor, if the participating provider or designee agrees to accept claims details for such payments electronically and provides accurate electronic funds transfer information to the payor.