House
File
736
-
Reprinted
HOUSE
FILE
736
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
HSB
225)
(As
Amended
and
Passed
by
the
House
March
25,
2021
)
A
BILL
FOR
An
Act
relating
to
limitations
on
activities
related
to
paid
1
claims
under
the
Medicaid
program,
and
including
effective
2
date
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
HF
736
(3)
89
pf/rh/md
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
The
limitations
specified
in
this
section
shall
not
apply
to
13
retroactive
Medicaid
cost
settlements
or
rate
changes
based
14
on
a
Medicaid
or
Medicare
cost
report.
Any
improper
payment
15
identified
through
a
review
may
be
resubmitted
by
the
provider
16
as
a
claims
adjustment.
17
Sec.
2.
EFFECTIVE
DATE.
This
Act,
being
deemed
of
immediate
18
importance,
takes
effect
upon
enactment.
19
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736
(3)
89
pf/rh/md
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1