H-4414.1  _______________________________________________

                          HOUSE BILL 2940

          _______________________________________________

State of Washington      55th Legislature     1998 Regular Session

By Representative Smith

Read first time 01/23/98.  Referred to Committee on Health Care.

Requiring prompt payment of providers by health carriers.

    AN ACT Relating to prompt payment of providers by health carriers; adding a new section to chapter 48.43 RCW; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 48.43 RCW to read as follows:

    (1) Health carriers shall make prompt payment to health care providers for health care services provided to enrollees of the health carrier.  For the purpose of this section, "prompt payment" means payment not later than the 30th day after a claim for payment is received by the carrier with documentation reasonably necessary to process the claim.  For claims in which the obligation of the carrier to pay the claim is not reasonably clear due to a good faith dispute or a good faith need for additional information reasonably necessary to process the claim, the carrier shall:  (a) Pay any undisputed portion of the claim within thirty days; (b) notify the provider of the dispute or needed documentation in a timely manner; and (c) pay the remainder of the claim owed within thirty days of receiving the necessary documentation or the resolution of the dispute.

    (2) Any health carrier that violates the requirements of subsection (1) of this section shall pay interest to the provider at the rate of twelve percent per annum on the amount of the claim from the date the payment should have been made under subsection (1) of this section until the date the payment actually is made.

    (3) This section applies to all claims made on or after July 1, 1998, unless a contract entered into before July 1, 1998, between the provider and carrier provides a specific remedy for untimely payment of the provider by the carrier.  This section applies to all claims made under contracts between providers and carriers entered into on or after July 1, 1998.

NEW SECTION. Sec. 2.  This act takes effect July 1, 1998.

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