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 -1- HF 736 (3) 89 pf/rh/md 1/ 1