Lourdes Winberry, Director of Managed Care for the George Washington University Hospital and Chair of DCHA s HMO Work Group, also joins me. When late payments are a persistent problem, some providers may withdraw from the networks or panels of offending payers, which then makes consistent access for enrollees a serious problem. Threat to Network Stability. Interruptions in cash flow disrupt financial relationships with contracted providers, especially private physicians and smaller community based facilities. Threat to Cash Flow.
Unpaid claims leave providers without the necessary cash to operate.
Extreme or widespread delays can force providers to obtain short-term loans to continue operating, which increases the costs of health care for everyone. The District is one of a handful of states that has not enacted prompt payment legislation. I have attached a list of the 42 states that have enacted prompt payment legislation. Federal rules require that Medicaid contracts with carriers must provide for payment of 90 percent of clean claims within 30 days of receipt, and 99 percent of clean claims within 90 days of receipt. Let me share the background of how Bill 14-100 came to be.