Amendments for HB25-1151
House Journal, February 19
44 HB25-1151 be amended as follows, and as so amended, be referred to
45 the Committee of the Whole with favorable
46 recommendation:
47
48 Amend printed bill, page 2, line 5, after "rules" insert "- report".
49
50 Page 2, line 6, after "(15) (b)" insert "(I)".
51
52 Page 2, line 15, strike "PROCESS," and substitute "PROCESS FOR CLAIMS
53 MADE FOR OUT-OF-NETWORK EMERGENCY SERVICES PROVIDED TO A
54 COVERED PERSON,".
55
56
1 Page 2, line 22, after the period add "THE COMMISSIONER SHALL
2 ANNUALLY REPORT ON THE USAGE OF THE BATCHING PROCESS AS PART OF
3 THE DIVISION'S PRESENTATION TO ITS COMMITTEE OF REFERENCE AT A
4 HEARING HELD PURSUANT TO THE "STATE MEASUREMENT FOR
5 ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT (SMART)
6 GOVERNMENT ACT" REQUIRED PURSUANT TO SECTION 2-7-203.".
7
8 Page 2, after line 23 insert:
9
10 "(II) (A) FOR CLAIMS THAT ALLEGE UNDERPAYMENT FOR A BILLED
11 CODE WHERE THERE IS A MANDATED OUT-OF-NETWORK REIMBURSEMENT
12 RATE PURSUANT TO THIS SECTION, A CLAIMANT MAY ONLY BATCH CLAIMS
13 IF THE CLAIMANT REQUESTS THAT THE DIVISION PROVIDE THE
14 REIMBURSEMENT RATES AS REQUIRED IN SUBSECTION (3)(d)(II) OF THIS
15 SECTION FOR THE DISPUTED CLAIMS, DETERMINES THAT THEY WERE
16 UNDERPAID, AND FILES A COMPLAINT WITH THE DIVISION AND THE
17 DIVISION DOES NOT ISSUE A FINAL DECISION WITHIN SIXTY DAYS AFTER
18 THE DATE THE COMPLAINT WAS FILED.
19 (B) FOR CLAIMS THAT WERE PAID FOR BY THE CARRIER FOR A
20 DIFFERENT BILLING CODE THAN THE BILLING CODE SUBMITTED BY THE
21 CLAIMANT RESULTING IN A LESSER PAYMENT TO THE CLAIMANT, THE
22 CLAIMANT MAY PROCEED DIRECTLY WITH THE ARBITRATION BATCHING
23 PROCESS TO DISPUTE THE CLAIMS.".
24
25 Page 3, line 9, strike "(1)" and substitute "(15)(d)(III)".
26
27
House Journal, February 26
30 Amendment No. 1, Health & Human Services Report, dated February 19,
31 2025, and placed in member’s bill file; Report also printed in House
32 Journal, February 20, 2025.
33
34 Amendment No. 2, by Representative Stewart R.:
35
36 Amend the Health and Human Services Committee Report, dated
37 February 19, 2025, page 1, strike line 2.
38
39 Page 1, strike lines 12 through 23.
40
41 Strike page 2.
42
43 As amended, ordered engrossed and placed on the Calendar for Third
44 Reading and Final Passage.