August 16, 2017

HB 17-1139: Exposing Medicaid Providers to Civil Damages for Improper Billing

On February 1, 2017, Reps. Lois Landgraf & Dafna Michaelson Jenet and Sens. John Kefalas & Beth Martinez Humenik introduced HB 17-1139, “Concerning Improving Medicaid Client Protections Through Effective Enforcement of Medicaid Provider Requirements.”

The bill subjects a provider of medicaid services to a civil monetary penalty if the provider improperly bills or seeks collection from a medicaid recipient or the estate of a medicaid recipient.

In addition, the bill allows the department of health care policy and financing (department) to require a corrective action plan from any provider who fails to comply with rules, manuals, or bulletins issued by the department, the medical services board, or the department’s fiscal agent or from a provider whose activities endanger the health, safety, or welfare of a medicaid recipient. Based on good cause, the department may suspend the enrollment of a medicaid provider for a period of time set forth in the bill. The provider has the right to appeal the suspension administratively.

The bill was introduced in the House and assigned to the Public Health Care & Human Services Committee.