HB 23-1295 Summary

• Requires the state Department of Health Care Policy and Financing to publish quarterly audit activity reports detailing recovery audit contractor audits, findings, overpayments, underpayments, appeals, and error rates on its website.

• Mandates at least quarterly provider trainings and stakeholder meetings regarding audits and reviews, and requires publication of recovery audit contracts, scopes of work, and contractor supervision information.

• Establishes a provider advisory group consisting of state department employees and representatives from physicians, hospitals, and other provider types to meet quarterly and review audit reports.

• Requires the Office of the State Auditor to conduct an independent review of the recovery audit contractor program during fiscal year 2023-24, examining federal compliance, contractor payment models, staffing qualifications, lookback periods, provider burden, and impacts on provider participation.

• Appropriates $850,000 to the Office of the State Auditor and $39,287 to the Department of Health Care Policy and Financing for fiscal year 2023-24 to implement audit review and improvement activities.