MS HB1297

Amends Section 83-41-219 to establish reciprocal time limits for health insurance issuers and payers to audit claims: if a provider has a deadline to submit a claim, the issuer/payer has the same time limit to audit and request reimbursement for invalid or overpaid claims.

Sets a 12-month maximum audit window for health insurance issuers or payers that do not impose claim submission deadlines on providers.

Exempts audits opened before July 1, 2012 from the new time limitation requirements.

Limits all Division of Medicaid audits of provider claims to a maximum of 5 years after final filing of the claim.

Exempts from time limits audits of pharmacies under Section 73-21-175 et seq. and claims involving misrepresentation, omission, concealment, or fraud by the health care provider.