Bill Text: MS SB2127 | 2010 | Regular Session | Enrolled
Bill Title: Health insurance; provide for reciprocal limitations on claim filing and claim audits.
Spectrum: Bipartisan Bill
Status: (Passed) 2010-03-17 - Approved by Governor [SB2127 Detail]
Download: Mississippi-2010-SB2127-Enrolled.html
MISSISSIPPI LEGISLATURE
2010 Regular Session
To: Insurance
By: Senator(s) Clarke, Dearing
Senate Bill 2127
(As Sent to Governor)
AN ACT TO CREATE A NEW SECTION TO PROVIDE FOR RECIPROCAL LIMITATIONS ON HEALTH INSURANCE CLAIM FILING AND CLAIM AUDITS; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) If any health insurance issuer or other health insurance benefit payer limits the time in which a health care provider or other person is required to submit a claim for payment, the health insurance issuer or other health insurance benefit payer shall have the same time limit following payment of the claim to perform any review or audit for reconsidering the validity of the claim and requesting reimbursement for payment of an invalid claim or overpayment of a claim.
(2) If any health insurance issuer or other health insurance benefit payer does not limit the time in which a health care provider or other person is required to submit a claim for payment, the health insurance issuer or other health insurance benefit payer may not request reimbursement or offset another claim payment for reimbursement of an invalid claim or overpayment of a claim more than twelve (12) months after the payment of an invalid or overpaid claim.
(3) Nothing in this act shall apply to claims submitted in the context of misrepresentation, omission, concealment, or fraud by the health care provider or other person.
(4) Nothing in this section shall apply to an audit of a pharmacy as provided in Section 73-21-175 et seq., nor to claims submitted by providers for reimbursement under the Mississippi Medicaid Program.
SECTION 2. This act shall take effect and be in force from and after July 1, 2010, and shall apply to health care claims submitted for payment on or after that date.
