A bill for an act relating to the standardization of claim submission and reimbursement processes of managed care organizations.

Summary

The bill orders the Department of Health and Human Services to set uniform rules for submitting and reimbursing Medicaid claims after July 1 2027. It defines “managed care contract” and “managed care organization” and forces both existing and future contracts with these insurers to follow the new process. The aim is to make payments more efficient, lawful, and aligned with actual costs.

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