HB 17-1139 (Landgraf & Michaelson Jenet/Kefalas & Martinez Humenik) Medicaid Provider Compliance Billing Safety Rules

Originally Posted: February 10, 2017
Last Updated: May 5, 2017

Summary

This bill will improve the Department of Health Care Policy and Financing’s Medicaid program integrity and fraud efforts while increasing client protections from improper balance billing. Currently, the Department has limited options for addressing issues with Medicaid providers that consistently improperly bill, have quality of care issues, or send clients to collections. This bill would give the Department additional options when providers engage in inappropriate practices, including the ability to request a written response from a provider, suspension of providers until they come into compliance, and financial penalties for balance billing if the provider is unwilling to void the bill or take the client out of collections. The Department’s current options, which include sending a warning letter or terminating a provider, are often not effective to change provider behavior or not feasible given the impact on a community of terminating a Medicaid provider.

Position

The Children’s Campaign supports this proposal as a way to protect Medicaid clients from inappropriate medical bills, by providing the Department with additional options to address provider issues more effectively and without adversely affecting access to care for Medicaid clients throughout the state.

Current Status

The bill passed the House and Senate and now heads to the governor’s desk for signature.

Previous Statuses


April 28, 2017

Passed the House unanimously and now heads to the Senate, where it has been assigned to the Senate State Veterans, & Military Affairs Committee.

April 21, 2017

The House Public Health Care & Human Services Committee heard testimony on the bill and laid it over for a vote at a later date.

April 14, 2017

Assigned to the House Public Health Care & Human Services Committee where it is scheduled to be heard on Tuesday, April 18, 2017 at 1:30 pm in Room 107.

April 7, 2017

Assigned to the House Public Health Care and Human Services Committee where it is scheduled to be heard on Tuesday, April 11th at 1:30 pm in Room 107.

February 10, 2017

Introduced in the House – Assigned to the House Public Health Care & Human Services Committee.