JEFFERSON CITY - As the summit on national health care raged in Washington on Thursday, a pair of bills in Missouri that would put money into the pockets of medical care providers more quickly unanimously passed the House and Senate.
Rep. Timothy Jones, R-St. Louis County, the sponsor of the House's version said the bill "will eventually, I believe, result in lowered health care costs because you're going to get rid of a lot of inefficiencies in the system, and providers are not going to have to spend manpower and time chasing down these claims that previously were not paid."
Jones said the bill would help clear up current ambiguities in the payment of health care insurance claims across the state.
"Ultimately, what this is going to do is provide a lot of certainty for both the providers -- whether they're rural or urban -- and the health insurance companies -- big and small -- in order to pay claims," he said.
Opponents of the legislation, however, said claim paying is a very complicated process, and health insurers must be considerate of the premium rates of their costumers. The opponents include America's Health Insurance Plans, Missouri Insurance Coalition, Blue Cross Blue Shield of Kansas City and Anthem Blue Cross Blue Shield of Missouri.
The bill, called "prompt pay" by some legislators, deletes a clause allowing carriers to suspend responding to a claim for an indefinite time. It also creates a penalty -- one percent of the claim per day -- for unpaid claims that exceed 45 days from the initial filing of the claim.
In addition, Jones' bill also defines a "clean claim." These claims have been deemed to be without faults and have all of the necessary paperwork. As a result, a "clean claim" has nothing about it that should prevent timely payment.
"If, at the end of that 45 days, the insurance companies still do not feel they have a claim that is valid, they can simply deny the claim and the parties can go to the historical methods they've had of arbitration. Or, if they have to sue on their contracts, they can do that as well," Jones said.
"For the insurers, it now puts some certainty into the claims that are going to be presented to them by inserting what's called the 'clean claim' definition into the law," Jones said.
Gov. Jay Nixon expressed his support for the bill and commended the chambers for their bipartisanship.
A statement e-mailed by Nixon's office on Wednesday said, "This legislation will help make sure that Missouri's health care providers, hospitals and rural doctors will be paid more quickly for the services they provide to their patients."
Last year, Nixon's office commissioned the Department of Insurance to study insurance company payment of claims to health care providers.
"The report recommends Missouri law be strengthened to make the medical claims process more efficient, by providing clear direction to both insurers and health care providers on their roles and responsibilities," John M. Huff, Department of Insurance director told Nixon in a letter dated Dec. 31 2009.
"While many insurers are meeting their financial obligations to providers, others are not," Huff wrote.
In a statement following Thursday's vote, Jones said the Department of Insurance's recommendations were a basis for the legislation.
"Those were all suggestions that we had identified last year," Jones said. "So everyone was pretty much on the same page."
The House and Senate appear to be on the same page too, with the Senate passing its version of the bill on the same day as the House.
Sen. Jim Lembke, D. St. Louis County, is sponsoring a prompt pay bill for the third year. The bill passed the Senate the last two years, but never made it through the House.
After passage on Thursday, the House and Senate will begin looking at the other chamber's bill.