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HF1963 (Legislative Session 94 (2025-2026))

Medical claims filing timelines, withdrawal management services, and mental health diagnostic services assessments provisions modified; and closure planning requirements imposed on peer recovery supports providers.

Related bill: SF1966

AI Generated Summary

Purpose of the Bill

The bill aims to amend existing human services laws related to medical claims processing, withdrawal management services, and peer recovery support.

Main Provisions

  • Claims Filing Timelines: The bill modifies the deadlines for healthcare providers to file medical claims. Initially, claims must be submitted within six months from the date of service. Exceptions can extend this period to 12 months if a significant disruption in operations is proven, or an additional six months if payment adjustments are made by the health plan or administrator.

  • Eligibility for Peer Recovery Support Services: New certification requirements for recovery community organizations are established to qualify as vendors for peer recovery support services. Organizations must be certified by an approved accrediting body by June 30, 2025. These entities must also be nonprofit and governed by people in recovery.

  • Withdrawal Management Services: Specifies the determination of the county of financial responsibility for withdrawal management services to ensure proper funding allocation.

  • Diagnostic Assessment Timelines: Adjusts timelines for mental health diagnostic assessments to be completed within ten days of a positive mental health screen in treatment facilities.

Significant Changes to Existing Law

  • Healthcare Claims Filing: Extends the allowable time for claims submission under certain conditions, promoting flexibility for healthcare providers impacted by operational disruptions or payment adjustments.

  • Peer Recovery Support: Introduces a formal process for recovery community organizations to become eligible vendors, potentially increasing accountability and service quality.

  • Counties and Financial Responsibility: Clearly defines county financial responsibility for withdrawal management services for better service coordination and cost management.

Relevant Terms

  • Claims Filing
  • Health Plan Company
  • Peer Recovery Support
  • Recovery Community Organization
  • Withdrawal Management
  • Diagnostic Assessment
  • American Society of Addiction Medicine (ASAM)

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 05, 2025HouseFloorActionIntroduction and first reading, referred toHuman Services Finance and Policy

Citations

 
[
  {
    "analysis": {
      "added": [
        "A new subsection clarifying disbursement rules."
      ],
      "removed": [
        "Eliminates previous requirement for municipal matching funds."
      ],
      "summary": "This bill modifies pension fund eligibility for volunteer firefighters under section 353G.06.",
      "modified": [
        "Adjusts pension payment schedule from annual to quarterly."
      ]
    },
    "citation": "353G.06"
  }
]

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