Bill Text: IA HSB501 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to limitations on activities related to paid claims under the Medicaid program, and including effective date provisions.(See HF 2268.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2024-02-01 - Committee report approving bill, renumbered as HF 2268. [HSB501 Detail]
Download: Iowa-2023-HSB501-Introduced.html
House
Study
Bill
501
-
Introduced
HOUSE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
BILL
BY
CHAIRPERSON
MEYER)
A
BILL
FOR
An
Act
relating
to
limitations
on
activities
related
to
paid
1
claims
under
the
Medicaid
program,
and
including
effective
2
date
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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Section
1.
NEW
SECTION
.
249A.42B
Limitations
on
activities
1
related
to
paid
claims
——
resubmission.
2
1.
Notwithstanding
any
provision
of
law
to
the
contrary,
3
any
post-payment
review
of
Medicaid
provider
claims
paid
under
4
either
Medicaid
fee-for-service
or
managed
care
administration
5
that
do
not
involve
fraud
or
misrepresentation
shall
be
6
limited
to
a
review
of
only
those
claims
for
which
no
more
than
7
twenty-four
months
have
elapsed
since
the
date
of
payment
of
8
the
claim.
9
2.
Additionally,
any
provider
overpayment
identified
for
10
which
twenty-four
months
or
more
have
elapsed
since
the
date
11
of
payment
of
the
claim
shall
not
be
subject
to
repayment
or
to
12
offset
against
future
reimbursement
of
claims
by
the
provider.
13
3.
The
limitations
specified
in
this
section
shall
not
apply
14
to
retroactive
Medicaid
cost
settlements
or
rate
changes
based
15
on
a
Medicaid
or
Medicare
cost
report.
16
4.
Any
improper
payment
identified
through
a
review
may
be
17
resubmitted
by
the
provider
as
a
claims
adjustment.
18
Sec.
2.
EFFECTIVE
DATE.
This
Act,
being
deemed
of
immediate
19
importance,
takes
effect
upon
enactment.
20
EXPLANATION
21
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
22
the
explanation’s
substance
by
the
members
of
the
general
assembly.
23
This
bill
relates
to
the
limitations
on
activities
related
24
to
paid
claims
under
the
Medicaid
program.
25
The
bill
provides
that
notwithstanding
any
provision
of
26
law
to
the
contrary,
any
post-payment
review
of
Medicaid
27
provider
claims
paid
under
either
Medicaid
fee-for-service
28
or
managed
care
administration
that
do
not
involve
fraud
or
29
misrepresentation
shall
be
limited
to
a
review
of
only
those
30
claims
for
which
no
more
than
24
months
have
elapsed
since
31
the
date
of
payment
of
the
claim.
Additionally,
any
provider
32
overpayment
identified
for
which
24
months
or
more
have
elapsed
33
since
the
date
of
payment
of
the
claim
shall
not
be
subject
34
to
repayment
or
to
offset
against
future
reimbursement
of
35
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