Amends TCA Section 71-05-117.

Current law requires that third parties respond to any inquiry by the state regarding a claim for payment for any healthcare item or service that is submitted not later than three years after the date of the provision of such healthcare item or service. This bill additionally requires that a third party for medical services must do the following, consistent with federal law: (1) Accept the state's right of recovery and the assignment to the state of the right of an individual or other entity to payment from the party for an item or service for which payment has been made under the state plan or under a waiver of such plan; (2) In the case of a responsible third party, other than Medicare plans, that requires prior authorization for an item or service furnished to an individual eligible to receive medical assistance under this chapter, accept authorization provided by the state that the item or service is covered under the state plan or under a waiver of such plan for such individual, as if such authorization were the prior authorization made by the third party for such item or service; and (3) Agree not to deny a claim submitted by the state solely on the basis of the date of submission of the claim, the type or format of the claim form, a failure to present proper documentation at the point of sale that is the basis of the claim, or in the case of a responsible third party, other than Medicare plans, a failure to obtain a prior authorization for the item or service for which the claim is being submitted, if: (A) The claim is submitted by the state within the three-year period beginning on the date the item or service was furnished; and (B) Any action by the state to enforce its rights with respect to such claim is commenced within six years of the state's submission of such claim. TIME FOR RESPONDING TO CLAIM Current law requires third parties to respond to requests for payment by providing payment on the claim, written request for additional information with which to process the claim, or written reason for denial of the claim, within 90 working days after receipt of written proof of loss or claim for payment for healthcare services provided to a recipient of medical assistance who is covered by the entity. This bill requires third parties to respond to requests for payment within 60 days.