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NY S08949
Bill
Status
1/20/2026
Primary Sponsor
Peter Harckham
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AI Summary
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Limits Medicaid overpayment recoupment when a provider's record submission method violated requirements at the time of the claim but complies with current updated guidelines or regulations
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Restricts the Medicaid Inspector General's recovery to only the actual claims reviewed, prohibiting statistical extrapolation to estimate broader overpayments in these cases
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Bars the Inspector General from initiating new or additional reviews against a provider on the same basis once such a determination is made
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Applies protections only when there is no fraud and services were actually provided to eligible beneficiaries
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Takes effect immediately and applies retroactively to pending audits and those under administrative or judicial review, not just future audits
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
ADVANCED TO THIRD READING
2/26/2026