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CT HB07190
Bill
Status
Passed
6/27/2017
Primary Sponsor
Human Services Committee
Click for details
AI Summary
- Establishes procedures for Medicaid provider audits requiring 30 days advance notice with audit methodology disclosure, except when health/safety risks or vendor fraud is suspected
- Prohibits audit findings based on extrapolation unless the extrapolated overpayment exceeds 1.75% of total claims paid during the audit period
- Requires preliminary audit reports within 60 days of audit conclusion, exit conferences with providers, and final reports within 60 days of the exit conference
- Allows providers 30 days to respond to audit discrepancies and permits contested case hearings; prevents overpayment recoupment from extrapolation findings while hearings are pending
- Exempts nonmedical home care providers (January 1 - May 1, 2017) and medical home health care providers (April 1 - August 1, 2017) from extrapolation of overpayments related to electronic visit verification system implementation errors
Legislative Description
An Act Concerning Medicaid Provider Audits And Electronic Visit Verification.
Last Action
Signed by the Governor
6/27/2017
Committee Referrals
Human Services2/27/2017
Full Bill Text
No bill text available