CS/CS/HB 939 - Medicaid Recoveries Summary

• Requires Medicaid providers to report changes in principal (officers, directors, owners with 5%+ stake) within 30 days; hospitals and nursing homes follow different controlling interest definitions under s. 408.803.

• Establishes liability for ownership changes where transferors remain liable for outstanding overpayments and administrative fines, and transferees are also liable for overpayments identified on or before the change effective date; requires 60-day advance notice and enrollment application from transferee.

• Authorizes Agency for Health Care Administration to enroll out-of-state providers within 50 miles of Florida border or physicians interpreting diagnostic tests via telecommunications; requires mandatory onsite inspection within 60 days of new provider application receipt.

• Modifies provider termination and sanction procedures by clarifying grounds for termination, limiting overpayment determinations to contemporaneous records, and specifying that accrued interest on withheld payments accrues at 10% annually after 14 days; changes overpayment reimbursement deadline from 35 to 30 days.

• Extends immunity from civil liability for persons reporting Medicaid fraud to include all fraudulent acts, fraud-related matters, and discussions conveyed to the agency in any manner; establishes June 30, 2014 repeal dates for Medicaid Fraud Strike Force and interagency agreement sections.