An Act Revising Medicaid Audit Requirements And Establishing Temporary Waivers For Providers Implementing Electronic Visit Verification.
Impact
This legislation directly impacts Medicaid service providers by aligning audit processes with the implementation of Electronic Visit Verification, a system mandated by the 21st Century Cures Act. The temporary waivers outlined in the bill protect both nonmedical and medical home health care providers from penalties related to errors in the rollout of EVV during specified timeframes. This protection is crucial as providers transition to this digital verification system, enabling them to maintain financial viability while adapting to new compliance requirements.
Summary
House Bill 07009 aims to revise the audit requirements for Medicaid service providers while establishing temporary waivers for those implementing Electronic Visit Verification (EVV). The bill significantly alters existing regulations by introducing a more structured approach to audits, which are essential for ensuring compliance among Medicaid providers. By amending Section 17b-99, the bill sets clear parameters for how audits should be conducted, including limits on claims that can be audited and requirements for notifying providers in advance. In particular, it specifies that no audits may cover claims older than thirty-six months, protecting providers from retrospective scrutiny over older claims.
Sentiment
The sentiment surrounding HB 07009 appears largely positive, with broad support from healthcare providers anticipating the necessary adjustments for EVV implementation. Advocates argue that the changes will enhance transparency and efficacy in Medicaid audits, making it easier for providers to adhere to requirements and minimize risks associated with non-compliance. However, there is a recognition of the challenges involved in shifting to electronic systems, underscoring a cautious optimism among stakeholders that these revisions will ultimately streamline operations and benefit the service delivery process.
Contention
Despite its positive reception, there are points of contention regarding the balance between rigorous auditing and the burden it places on service providers. Some advocates for services such as home care worry that too stringent an enforcement of audit requirements could inhibit the ability of smaller providers to remain competitive. There are fears that administrative complexities could lead to unintentional compliance failures, especially among those transitioning to new electronic systems. Overall, the bill's success will depend on effective implementation and continued dialogue between the Department of Social Services and the various stakeholders involved.
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