Year: 2011
Resolution Number: 79
Action Taken: Approved
Status:
Author(s): Patrick J. Droste, MS, MD
Sponsor: Domenic R. Federico, MD
On behalf of: Kent County Delegation
Committee: B (Legislation)
Resolved Section(s):
RESOLVED: That MSMS work for legislation that provides for all of the following:1) Authorization for specific service(s) is associated with payment for services rendered.2) Reimbursement for services rendered is received within 30 days.3) Services with “authorization” cannot be denied retrospectively with request for return payment.RATIONALE: All of the members of the Committee had firsthand knowledge of the practice of insurers improperly withholding payment by retroactively denying payment for services that were prior authorized. The prevalence of this practice by insurers was troubling to the Committee and reinforced the need for MSMS to take action on this issue.
RESOLVED: That MSMS work for legislation that provides for all of the following:1) Authorization for specific service(s) is associated with payment for services rendered.2) Reimbursement for services rendered is received within 30 days.3) Services with “authorization” cannot be denied retrospectively with request for return payment.RATIONALE: All of the members of the Committee had firsthand knowledge of the practice of insurers improperly withholding payment by retroactively denying payment for services that were prior authorized. The prevalence of this practice by insurers was troubling to the Committee and reinforced the need for MSMS to take action on this issue.
Fiscal Note: NULL
Resolution: View PDF for Domenic R. Federico, MD, for the Kent County Delegation