CT HB05257

Requires the Commissioner of Social Services to report to the joint standing committee on human services by July 1, 2017, on Medicaid audits conducted from July 1, 2015, to June 30, 2016, including the percentage of providers subject to extrapolation, amounts of overpayments discovered, and changes compared to the prior fiscal year.

Mandates that audit preliminary reports be provided to audited facilities within 60 days of audit conclusion and must include clear, objective rationale for any cost disallowances with specific citations to applicable statutes or regulations.

Requires the commissioner to apply only statutes or regulations specific to the type of program or facility being audited and to apply Medicare audit rules when state regulations are absent.

Prohibits the commissioner from disallowing costs without citing applicable statutes, regulations, or Medicare audit rules and providing a clear written explanation of how those rules were applied.

Effective July 1, 2016.