House Bill No. [insert number] aims to enhance third-party liability regulations concerning prior authorizations and state claim inquiries related to medical assistance in Louisiana. The bill introduces new provisions under R.S. 46:446.2, specifically sections (E) and (F). Section (E) mandates that third parties requiring prior authorization for medical items or services must accept authorizations provided by the department as valid, treating them as if they were prior authorizations made by the third party. Section (F) outlines the responsibilities of third parties regarding claims processing, including a requirement to respond to inquiries from the department within sixty days and prohibits denial of claims based solely on submission dates, claim formats, or documentation issues at the point of sale.

Additionally, the bill stipulates that third parties cannot deny claims based on the lack of prior authorization if the department submits the claim within three years of the service date and initiates enforcement actions within six years. This legislation is designed to streamline the claims process and ensure that individuals eligible for medical assistance receive the necessary support without undue barriers. The bill will take effect upon the governor's signature or after the designated period for bills to become law without a signature.