Prohibits the recovery of reimbursements paid on claims in the medical assistance program if the provider can verify that the patient visit occurred or the service or item was provided.

Healthcare

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: Senator Hayden
Last action: 2025-06-27
Official status: In Senate Committee
Effective date: Not listed

Plain English Breakdown

The plain English breakdown is still being put together. The official documents below are already here.

Bill History

2025-06-27 Senate
In committee upon adjournment.
2025-02-25 Senate
Public Hearing held.
2025-01-17 Senate
Referred to Health Care.
2025-01-13 Senate
Introduction and first reading. Referred to President's desk.

Official Summary Text

Digest: The Act limits when OHA may claw back moneys paid to Medicaid providers. (Flesch Readability Score: 63.4).
Prohibits the recovery of reimbursements paid on claims in the medical assistance program if the provider can verify that the patient visit occurred or the service or item was provided. Prohibits the recovery of reimbursements based on a sample of a provider's claims unless a similar error rate is found in a sample of at least 15 percent of the provider's claims.
Applies to audits of claims for the reimbursement of items or services provided on or after January 1, 2019, if the claims have not been fully adjudicated.
Declares an emergency, effective on passage.
Relating to: Relating to medical assistance provider audits; declaring an emergency.
Current location: In Senate Committee