This article first appeared in the St. Louis Beacon, Sept. 11, 2009 - Missouri Gov. Jay Nixon just announced that he has "ordered the state Department of Insurance to determine whether health insurance companies in Missouri are withholding reimbursement payments to health care providers for unreasonable lengths of time."
"Doctors, hospitals and other providers have complained to the department that after treating patients and submitting bills for reimbursements, health insurance companies are not paying the bills in a timely manner,'' the governor's office said in its release.
Nixon's action comes just days after his office also announced that hospitals have been overpaid by the state after over-estimating how much they were owed for caring for patients covered by Medicaid, the state-federal program that covers care for the poor and disabled.
The state is changing its payment formula, which officials say could cut payments to hospitals by close to $140 million a year.
Nixon's latest move appears to be aimed at cooling any tensions with the state's hospitals, who had sought to help him earlier this year by offering to pay more fees to the state that would be used to obtain more federal money for Medicaid, and cover thousands more Missourians. The Legislature blocked the plan.
His action also puts the Democratic governor on the same political page as the Democrats in Washington, including President Barack Obama, who also are taking aim at insurance companies in their quest to make changes in the nation's health care system.
According to the governor's office today, Nixon has asked the Department of Insurance "to report on the scope of the problem and make recommendations on the sufficiency of Missouri’s 'prompt pay' statutes. State law requires health insurers to respond to and pay claims to health care providers within specific time frames, or they face penalties and interest payments."
The department is to report its findings by December 31 to Nixon and the Legislature.
"This year the Department of Insurance has fielded complaints from health care providers involving thousands of unpaid claims. Complaint volume for 2009 is already six times as high as it was for all of 2006," Nixon's office added. “The lack of timely claims payments may significantly compromise the ability of hospitals and health care providers to continue to provide quality medical care to Missourians."
Among its examples:
"· A rural hospital in eastern Missouri has waited more than two years to be reimbursed for $300,000 in claims dating back to 2007.
"· A St. Louis-area hospital has filed complaints regarding more than 3,000 unpaid claims..."
“This problem hits small and rural providers hardest, straining their cash flow and requiring them to dedicate staff time to paperwork and collections,” said John M. Huff, director of the Missouri Department of Insurance, Financial Institutions and Professional Registration, in a statement.
