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OR SB61
Bill
Status
6/27/2025
Primary Sponsor
Cedric Hayden
Click for details
AI Summary
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Prohibits Oregon Health Authority from recovering Medicaid reimbursements when providers submit documentation verifying patient visits occurred or services were provided, including treatment plans, clinical assessments, progress notes, patient attestations, referrals, or prescriptions
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Limits recovery for behavioral health billing code errors to only the difference between the amount paid and the correct reimbursement amount
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Prohibits extrapolating error rates from sample audits to a provider's full claims unless a second sample of at least 15% of claims confirms a consistent error rate
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Applies retroactively to audits of claims for services provided on or after January 1, 2019, if not yet fully adjudicated through administrative or judicial processes
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Declares an emergency, making the act effective immediately upon passage
Legislative Description
Relating to medical assistance provider audits; declaring an emergency.
Last Action
In committee upon adjournment.
6/27/2025