Bill > HB732

This bill establishes the Prompt Cost Report Reimbursement Act, which aims to improve the reimbursement process for critical access hospitals participating in Montana Medicaid. Currently, Montana Medicaid delays settling cost reports until the Medicare administrative contractor completes a final desk audit, which can result in multi-year delays in reimbursement. The bill requires the Department of Public Health and Human Services to perform a tentative retroactive adjustment within 240 days of receiving a cost report, making an interim settlement and payment to the provider. If there's an overpayment, the provider has 60 days to repay or establish a repayment schedule. After the Medicare administrative contractor completes its final desk review or audit, the department will perform a final retroactive adjustment, with the provider having 60 days to repay any overpayment or the department reimbursing any underpayment within 90 days. The bill also appropriates $33,900 for fiscal year 2025 and $7,500 for fiscal year 2026 from both the hospital Medicaid reimbursement account and federal special revenue fund to support these cost report settlements. The act is retroactively applicable to cost reports submitted prior to its effective date, with the goal of aligning Montana Medicaid's practices more closely with Medicare's and ensuring timely and accurate reimbursement for critical access hospitals.

Health and Social Services

https://bills.legmt.gov/#/laws/bill/2/LC4251