Senate Bill 414 Summary

• Office of the Secretary of Family and Social Services may exclude persons from state administered health care programs for fraud, abuse, criminal convictions related to healthcare delivery, patient neglect or abuse, billing irregularities, license revocation, or failure to grant access to inspectors.

• Office of the Secretary must maintain and provide a list of excluded persons to participating healthcare providers, and may not reimburse excluded persons, their owners (5%+ stake), or their officers and managing employees.

• Medicaid providers and applicants must submit a $50,000 surety bond to the office, with an additional $50,000 bond for each adverse judgment or final order within the preceding 10 years, effective by October 15, 2010 for existing providers.

• Surety bonds must be continuous and cover duplicate, erroneous, or false claims paid to providers, with sureties required to pay valid claims within 30 days of notice; provider billing privileges are revoked for lapses in coverage.

• Providers convicted under IC 35-43-5-7.1 are ineligible to participate in Medicaid for 10 years after conviction, and providers may appeal exclusions or sanctions under established rules.