HB 17-1139 Summary

• Establishes civil monetary penalties of $100 per violation for providers who bill Medicaid recipients directly or through collection agencies in violation of billing restrictions, plus refund of unlawfully received amounts with statutory interest.

• Creates a safe harbor provision allowing providers to avoid penalties if they void the bill, return unlawfully received amounts, and resolve collection actions within 30 days of state department notification.

• Adds exception to penalties when recipients knowingly misrepresent their Medicaid coverage status and the provider submits documentation establishing good cause for an exception.

• Authorizes the Department of Health Care Policy and Financing to request written responses from non-compliant providers, who have 30 days to explain how they will achieve compliance or dispute the department's findings.

• Excludes refunds received by Medicaid recipients from income and resource calculations for determining eligibility and benefit amounts under state-funded programs.