What changed in HF 736
The bill as introduced, compared with the version both chambers passed (89th General Assembly). 2 adopted amendments account for the changes.
0 passages reworded, 4 added and 3 removed; 0 of 7 unchanged.
Removed AddedIntroduced textText as passedAmendments
Compares wording only. The printed bills also mark changes to existing law with strikes and underlines, which aren’t shown here.
Section 1.
Section 1. MEDICAID PROGRAM —— LIMITATIONS ON ACTIVITIES RELATED TO PAID CLAIMS —— RESUBMISSION. Notwithstanding any provision of law to the contrary, any post-payment review of Medicaid provider claims paid under either Medicaid fee-for-service or managed care administration that do not involve fraud or misrepresentation shall be limited to a review of only those claims for which no more than twenty-four months have elapsed since the date of payment of the claim. Additionally, any provider overpayment identified for which twenty-four months or more have elapsed since the date of payment of the claim shall not be subject to repayment or to offset against future reimbursement of claims by the provider. Any improper payment identified through a review may be resubmitted by the provider as a claims adjustment.
NEW SECTION. 249A.42A Overpayment —— subsequent ineligibility of recipient —— recovery —— recoupment —— reimbursement. Notwithstanding any provision to the contrary, if a recipient is deemed ineligible for medical assistance following delivery of care or service by a provider, in an administrative action to recover an overpayment to the provider based solely on the grounds of such recipient’s ineligibility, the department acting as the state Medicaid agency shall reimburse the provider for any recoupment of an overpayment using state-only funds for care or services delivered if all of the following conditions are met:
Sec.
1. The provider verified eligibility through the eligibility and verification system or the secure web portal of, and obtained any necessary prior authorization for, the recipient on whose behalf payment was made to the provider prior to the delivery of care or service to the recipient.
2. EFFECTIVE DATE. This Act, being deemed of immediate importance, takes effect upon enactment.
2. The provider documented the eligibility verification performed and any necessary prior authorization obtained pursuant to paragraph “a” in a manner and format established by the department by rule, and retained the required documentation in the recipient’s file.