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Bill > HF2142

IA HF2142

IA HF2142
A bill for an act relating to limitations on activities related to paid claims under the Medicaid program, and including effective date provisions.

summary

Introduced
01/21/2026
In Committee
01/21/2026
Crossed Over
Passed
Dead

Introduced Session

91st General Assembly

Bill Summary

This bill relates to the limitations on activities related to paid claims under the Medicaid program. The bill provides that notwithstanding any provision of law to the contrary, any post-payment review of Medicaid provider claims paid under either Medicaid fee-for-service or managed care administration that do not involve fraud or misrepresentation shall be limited to a review of only those claims for which no more than 12 months have elapsed since the date of payment of the claim. Additionally, any provider overpayment identified for which 12 months or more have elapsed since the date of payment of the claim shall not be subject to repayment or to offset against future reimbursement of claims by the provider. Any improper payment identified through a review may be resubmitted by the provider as a claims adjustment. The bill takes effect upon enactment.

AI Summary

This bill establishes new limitations on how the state can review and recover payments made under the Medicaid program, which is a government health insurance program for low-income individuals. Specifically, for claims that do not involve fraud or misrepresentation, the state can only review claims paid within the last 12 months. If an overpayment is found on a claim that was paid more than 12 months ago, the provider will not have to repay it or have it deducted from future payments. However, if a provider identifies an improper payment themselves, they can resubmit it as a claims adjustment. These limitations do not apply to retroactive adjustments for Medicaid costs or changes in payment rates based on cost reports. The bill takes effect immediately upon being signed into law.

Committee Categories

Health and Social Services

Sponsors (11)

Last Action

Introduced, referred to Health and Human Services. H.J. 134. (on 01/21/2026)

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