MO HB2057

Amends Section 208.215 to require health benefit plans, third-party administrators, administrative service organizations, and pharmacy benefits managers to process and pay all properly submitted MO HealthNet subrogation claims within three years of service provision, regardless of other timely filing requirements or claim form type.

Establishes that third-party payers must pay subrogation claims if enforcement action by the state is commenced within six years of claim submission, eliminating defenses based on documentation or prior authorization failures.

Changes terminology from "recipient" to "participant" throughout the statute and clarifies that MO HealthNet computerized records certified by the director constitute prima facie evidence of moneys expended and debt owed to the state.

Requires third-party payers to provide MO HealthNet division with 270/271 Health Care Eligibility Benefits Inquiry and Response information upon request, excluding accident-only and fixed indemnity insurance policies.

Maintains existing provisions regarding liens, recovery procedures, participant cooperation requirements, and the division's authority to compromise claims based on cost-effectiveness analysis.