General Assembly Raised Bill No. 243
February Session, 2018 LCO No. 1474
*01474_______HS_*
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
General Assembly
Raised Bill No. 243
February Session, 2018
LCO No. 1474
*01474_______HS_*
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING AUDITS OF MEDICAL ASSISTANCE PROVIDERS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Subdivision (5) of subsection (d) of section 17b-99 of the 2018 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(5) In conducting any audit pursuant to this subsection, the commissioner, or any entity with which the commissioner contracts to conduct such audit, shall accept (A) as sufficient proof of a written order: A photocopy, facsimile image, an electronically maintained document or original pen and ink document, and (B) as sufficient proof of delivery of a covered item or service: A receipt signed by the recipient of medical assistance or a nursing facility representative or, in the case of delivery of a covered item or service by a shipping or delivery service, a supplier's detailed shipping invoice and the delivery service tracking information substantiating delivery to the address of the medical assistance recipient. A provider, in complying with the requirements of any such audit, shall be allowed not less than thirty days to provide documentation in connection with any discrepancy discovered and brought to the attention of such provider in the course of any such audit. Such documentation may include evidence that errors concerning payment and billing resulted from a provider's transition to a new payment or billing service or accounting system. The commissioner shall not calculate an overpayment based on extrapolation or attempt to recover such extrapolated overpayment when the provider presents credible evidence that an error by the commissioner, or any entity with which the commissioner contracts to conduct an audit pursuant to this subsection, caused the overpayment, provided the commissioner may recover the amount of the original overpayment.
This act shall take effect as follows and shall amend the following sections:
Section 1 from passage 17b-99(d)(5)
This act shall take effect as follows and shall amend the following sections:
Section 1
from passage
17b-99(d)(5)
Statement of Purpose:
To clarify documentation requirements for audits of providers of medical assistance.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]