Wednesday, January 21, 2015

HB 237

Albert Olzewski

Providing requirements for Medicaid overpayment audits

1 comment:

  1. PHC is neutral on this bill. Background info from the Montana Primary Care Association "On Wednesday, MPCA will support a bill brought by the Montana Dental Association to establish guidelines for Medicaid overpayment audits. This is largely a proactive bill, drafted in response to concerns about audit trends in other states that may eventually effect Montana. (None of our CHCs have reported any experience with Medicaid audits.) The legislation’s key features are an establishment of timelines for the audit process (providers have 45 days to produce the records, and after that the audit must be completed within 60 days), the requirement of peer review (i.e., payments for dental services should be reviewed by another dentist), and the prohibition of extrapolation (e.g., if 10% of the pulled records show overpayment, this law would prohibit the Dept from extrapolating that 10% of all payments are overpaid)."


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