US Laws, Codes, Statutes & Cases

     62A.317 Standards for claims payment. 

    (a) An issuer shall comply with section 1882(c)(3) of the 
 federal Social Security Act, as enacted by section 4081(b)(2)(C) 
 of the Omnibus Budget Reconciliation Act of 1987 (OBRA), Public 
 Law 100-203, by: 

    (1) accepting a notice from a Medicare carrier on duly 
 assigned claims submitted by Medicare participating physicians 
 and suppliers as a claim for benefits in place of any other 
 claim form otherwise required and making a payment determination 
 on the basis of the information contained in that notice; 

    (2) notifying the Medicare participating physician or 
 supplier and the beneficiary of the payment determination; 

    (3) paying the Medicare participating physician or supplier 
 directly; 

    (4) furnishing, at the time of enrollment, each enrollee 
 with a card listing the policy or certificate name, number, and 
 a central mailing address to which notices from a Medicare 
 carrier may be sent; 

    (5) paying user fees for claim notices that are transmitted 
 electronically or otherwise; and 

    (6) providing to the secretary of health and human 
 services, at least annually, a central mailing address to which 
 all claims may be sent by Medicare carriers. 

    (b) Compliance with the requirements in paragraph (a) shall 
 be certified on the Medicare supplement insurance experience 
 reporting form. 

    HIST: 1992 c 554 art 1 s 6 

Copyright 2005 by the Office of Revisor of Statutes, State of Minnesota.