H.F. 736 Section 1. MEDICAID PROGRAM —— LIMITATIONS ON ACTIVITIES 1 RELATED TO PAID CLAIMS —— RESUBMISSION. Notwithstanding any 2 provision of law to the contrary, any post-payment review 3 of Medicaid provider claims paid under either Medicaid 4 fee-for-service or managed care administration that do not 5 involve fraud or misrepresentation shall be limited to a 6 review of only those claims for which no more than twenty-four 7 months have elapsed since the date of payment of the claim. 8 Additionally, any provider overpayment identified for which 9 twenty-four months or more have elapsed since the date of 10 payment of the claim shall not be subject to repayment or to 11 offset against future reimbursement of claims by the provider. 12 Any improper payment identified through a review may be 13 resubmitted by the provider as a claims adjustment. 14 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate 15 importance, takes effect upon enactment. 16 EXPLANATION 17 The inclusion of this explanation does not constitute agreement with 18 the explanation’s substance by the members of the general assembly. 19 This bill relates to the limitations on activities related 20 to paid claims under the Medicaid program. 21 The bill provides that notwithstanding any provision of 22 law to the contrary, any post-payment review of Medicaid 23 provider claims paid under either Medicaid fee-for-service 24 or managed care administration that do not involve fraud or 25 misrepresentation shall be limited to a review of only those 26 claims for which no more than 24 months have elapsed since 27 the date of payment of the claim. Additionally, any provider 28 overpayment identified for which 24 months or more have elapsed 29 since the date of payment of the claim shall not be subject 30 to repayment or to offset against future reimbursement of 31 claims by the provider. Any improper payment identified 32 through a review may be resubmitted by the provider as a claims 33 adjustment. 34 The bill take effect upon enactment. 35 -1- LSB 2593HV (2) 89 pf/rh 1/ 1