An Act Concerning Medicaid Provider Audits.
If enacted, HB 5494 will amend existing regulations outlined in section 17b-99 of the Connecticut General Statutes. The adjustments would necessitate the Department of Social Services to provide enhanced outreach and education to Medicaid providers, thereby reducing errors in claims and payments. By delineating accepted methods for providers to contest findings of overpayment, the bill empowers them to challenge the results of audits more effectively, which may lead to greater accountability within the Medicaid system.
House Bill 5494, introduced by Representative Abercrombie and Senator Moore, focuses on improving the audit process for Medicaid providers. The primary intent of the bill is to establish clear parameters around the use of extrapolation in these audits, ensuring that the audits are executed in a fair and consistent manner. This legislation aims to protect providers from unfair assessments by specifying minimum standards for statistical sampling and error rates, thus promoting a more transparent auditing process.
The passage of HB 5494 is anticipated to spark discussions among stakeholders involved in Medicaid administration and provider services. While proponents are likely to argue that the bill will lead to more equitable auditing practices, critics may voice concerns regarding the potential administrative burden on the Department of Social Services to implement these new standards effectively. The complexity associated with these regulations may also raise questions about their execution and monitoring.