SB61: Relating to medical assistance provider audits; declaring an emergency.

Legislative Summary

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.