WeVote
Log In

Bill

AS

Bill

HB 565

MEDICAID: Provides relative to third-party liability, claim adjudication, and timeliness of such within the state medical assistance program (EN SEE FISC NOTE GF EX)

2025 Regular Session Introduced by Annie Spell

Louisiana law establishes timelines for Medicaid claim processing and third-party liability procedures to improve administrative efficiency in state healthcare reimbursement.

Signed by the Governor. Becomes Act No. 293.
0
WeVote Research Nonpartisan
Bill Summary · HB 565

Legislative bill overview

HB 565 modifies Louisiana's Medicaid program to establish clearer procedures for third-party liability (when insurance or other entities are responsible for medical costs) and sets specific timelines for how quickly Medicaid claims must be adjudicated (processed and decided). The bill addresses administrative efficiency in the state medical assistance program by standardizing claim processing requirements.

Why is this important

Medicaid processes millions of claims annually, and delays in adjudication can affect provider reimbursement and patient access to care. Clarifying third-party liability rules prevents duplicate payments and ensures the right payer covers services first. Establishing timeliness requirements creates accountability and predictability for healthcare providers relying on Medicaid payments.

Potential points of contention

  • Cost implications: The fiscal note suggests budget impacts (GF EX designation), though specifics aren't detailed—stricter timelines or claim processing may require additional staffing or system upgrades
  • Provider burden: New claim submission or documentation requirements tied to third-party liability determinations could increase administrative work for hospitals and clinics
  • Insurance coordination complexity: Tighter third-party liability rules might delay payments while determining whether other insurance should pay first, potentially creating payment gaps

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.