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NY A09553
Bill
Status
Introduced
1/14/2026
Primary Sponsor
Amy Paulin
Click for details
AI Summary
- Limits Medicaid overpayment recoupment when a provider's record submission violated requirements at the time of the claim but now complies due to subsequent changes in guidelines or regulations
- Restricts recoupment to only the actual claims reviewed by the Medicaid Inspector General, prohibiting extrapolation to estimate broader overpayments
- Prohibits the Inspector General from initiating new or additional reviews against providers on the same basis once a determination is made
- Protections do not apply in cases of fraud, reimbursement for services not actually provided, or services to ineligible beneficiaries
- Applies immediately to new audits, pending audits, and concluded audits currently under administrative or judicial review
Legislative Description
Limits the reimbursement amount of certain overpayment claims and reviews where such overpayment was due to the provider's submission of records which were not in accordance with program requirements at the time but which were in accordance with current requirements as a result of changes to guidelines or regulations.
Last Action
reported referred to ways and means
2/11/2026
Committee Referrals
Ways and Means2/11/2026
Health1/14/2026
Full Bill Text
No bill text available