HB 1521 Summary: Health Care Fraud

• Extends home health agency licensing restrictions through July 1, 2012 in counties with fewer than 1,200 elderly residents per agency, with exemption for accredited agencies licensed 5+ years in good standing.

• Increases Medicaid provider record retention from 5 to 6 years and requires providers to report changes in ownership, officers, directors, and shareholders with 5%+ ownership within 30 days.

• Authorizes immediate suspension or termination of Medicaid providers for criminal convictions related to healthcare delivery, patient abuse/neglect, Medicaid fraud, or conviction of specific federal offenses.

• Requires Medicaid provider payment arrangements within 35 days after termination/suspension order and allows agency to withhold reimbursement for providers failing to pay fines or comply with repayment plans.

• Adds "affiliate" and "affiliated person" definitions for health professions, includes administrative complaints and arrests in practitioner profiles, and authorizes emergency license suspension for healthcare practitioners convicted of healthcare-related crimes.