Human Services Committee

JOINT FAVORABLE REPORT

Bill No.:

HB-5257

Title:

AN ACT CONCERNING MEDICAID PROVIDER AUDITS.

Vote Date:

3/17/2016

Vote Action:

Joint Favorable Substitute

PH Date:

3/3/2016

File No.:

SPONSORS OF BILL:

Human Services Committee

REASONS FOR BILL:

This bill requires the Commissioner of Social Services to report to the General Assembly committee having cognizance over human services on the effectiveness of any changes made in Medicaid provider audit system. This report will include the percentage of providers subject to extrapolation and the amount of overpayments discovered in these audits, as well as any increase or decrease in the use of extrapolation and overpayment discoveries as compared to years prior to the scope of this report (July 1, 2015 to June 30, 2016).

Substitute language adds requirements for audits of long-term care facilities, including the requirement that DSS not disallow costs or designate costs as unreasonable without citing specific basis in law or regulation; requires adoption of Medicare audit rules in absence of state regulations applying to costs.

RESPONSE FROM ADMINISTRATION/AGENCY:

Roderick L. Bremby, Commissioner, of Connecticut Department of Social Services, opposes this bill due to limited staff and resources.

NATURE AND SOURCES OF SUPPORT:

Mag Morelli, President of LeadingAge Connecticut:

Submitted written testimony in supporting of this bill, LeadingAge would like to thank the Human Services Committee for the attention they give relating issues surrounding the Medicaid provider audits.

NATURE AND SOURCES OF OPPOSITION:

None Expressed

Reported by: Monique Wrice

Date: March 29, 2016