MO SB799

Establishes that health benefit plans, third party administrators, administrative service organizations, and pharmacy benefits managers must process and pay properly submitted MO HealthNet subrogation claims within three years of service provision, regardless of other timely filing requirements or claim form format issues

Requires individuals pursuing legal claims against liable third parties to promptly notify the MO HealthNet division upon actual knowledge that MO HealthNet benefits have been paid, and notify the division of any legal proceedings, settlements, or claim results within thirty days

Mandates participants receiving third-party benefits or settlement proceeds to either repay the division within sixty days of receipt or place the full benefit amount in trust pending judicial or administrative determination of the division's recovery rights

Authorizes the MO HealthNet division to request information from third-party payers in the 270/271 Health Care Eligibility Benefits Inquiry and Response format under HIPAA, excluding accident-only, specified disease, disability income, and fixed indemnity insurance policies

Allows the department director to compromise or waive claims when recovery cost exceeds expected recovery amount or efforts would not be cost-effective, based on liability issues, available settlement funds, and estimated pursuit costs