CT HB05281

Requires the Commissioner of Social Services to conduct random quarterly audits of 15% of providers participating in social services programs, effective July 1, 2012.

Mandates providers notify the commissioner within 30 days of employing any person convicted of fraud in Medicare, Medicaid, AFDC, general assistance, or other state-sponsored programs, and requires termination of such vendors.

Establishes audit procedures including 30-day advance notice to providers (except when health/safety risks or fraud suspected), 30-day response period for documentation, preliminary reports within 60 days, and appeal rights to Superior Court.

Prohibits findings of overpayment based on extrapolated projections unless there is sustained payment error, failed educational intervention, or claims exceeding $150,000 annually.

Adds requirement for Commissioner of Social Services to consult with Chief State's Attorney to identify staff and resources for fraud enforcement and prevention in state-sponsored social services programs.