2000 Minnesota Statutes

     62Q.75 Prompt payment required. 

    Subdivision 1.    Definitions.  (a) For purposes of this 
 section, the following terms have the meanings given to them. 

    (b) "Clean claim" means a claim that has no defect or 
 impropriety, including any lack of any required substantiating 
 documentation, or particular circumstance requiring special 
 treatment that prevents timely payment from being made on a 
 claim under this section. 

    (c) "Third-party administrator" means a third-party 
 administrator or other entity subject to section 60A.23, 
 subdivision 8, and Minnesota Rules, chapter 2767. 

    Subd. 2.    Claims payments.  (a) This section applies 
 to clean claims submitted to a health plan company or 
 third-party administrator for services provided by any: 

    (1) health care provider, except a provider licensed under 
 chapter 151; 

    (2) home health care provider, as defined in section 
 144A.43, subdivision 4; or 

    (3) health care facility. 

 All health plan companies and third-party administrators must 
 pay or deny claims that are clean claims within 30 calendar days 
 after the date upon which the health plan company or third-party 
 administrator received the claim. 

    (b) If a health plan company or third-party administrator 
 does not pay or deny a clean claim within the period provided in 
 paragraph (a), the health plan company or third-party 
 administrator must pay interest on the claim for the period 
 beginning on the day after the required payment date specified 
 in paragraph (a) and ending on the date on which the health plan 
 company or third-party administrator makes the payment or denies 
 the claim.  In any payment, the health plan company or 
 third-party administrator must itemize any interest payment 
 being made separately from other payments being made for 
 services provided.  The health plan company or third-party 
 administrator may, at its discretion, require the health care 
 provider to bill the health plan company or third-party 
 administrator for the interest required under this section 
 before any interest payment is made. 

    (c) The rate of interest paid by a health plan company or 
 third-party administrator under this subdivision shall be 1.5 
 percent per month or any part of a month. 

    (d) A health plan company or third-party administrator is 
 not required to make an interest payment on a claim for which 
 payment has been delayed for purposes of reviewing potentially 
 fraudulent or abusive billing practices. 

    (e) The commissioner may not assess a financial 
 administrative penalty against a health plan company for 
 violation of this subdivision. 

    HIST: 2000 c 349 s 1