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GA HB916
Bill
Status
Vetoed
5/3/2016
Primary Sponsor
Dustin Hightower
Click for details
AI Summary
- Removes the exception that allowed the Department of Community Health to bypass the Pharmacy Audit Bill of Rights protections when conducting audits of medical assistance providers under Article 7 of Chapter 4 of Title 49
- Prohibits clerical, record-keeping, typographical, scrivener's, computer, billing, coding, or documentation errors by medical assistance providers from constituting fraud or serving as a basis for full payment recoupment; criminal penalties require proof of intent to commit fraud
- Grants providers a 30-day correction period after receiving notice of an error, omission, or incomplete documentation found during an audit or review to resolve the issue before any recoupment can occur
- Limits recoupment to the amount of any actual overpayment when errors result in excess payments, rather than allowing full payment recoupment
- Extends these same protections broadly to any entity receiving reimbursement from a state agency, and guarantees both medical assistance providers and other entities the right to an administrative hearing for any attempted withholding or recoupment
Legislative Description
"The Pharmacy Audit Bill of Rights"; certain audits conducted by the Department of Community Health; remove exception; provisions
Last Action
Veto V10
5/3/2016
Full Bill Text
No bill text available