s_sa_2017a_2017-05-01t13:37:50z4 Hearing Summary

Date: 05/01/2017

Location: SCR 357

03:00 PM -- HB17-1139



Senator Martinez Humenik, co-prime sponsor, presented House Bill 17-1139. Under the reengrossed bill, if a health care provider improperly bills or seeks collection from a Medicaid client or his or her estate, the provider:



• must refund any amount unlawfully received with interest;

• must pay a civil monetary penalty of $100 for each violation; and

• is liable for all amounts submitted to a collection agency in the name of the Medicaid client.



A provider is not liable for the civil monetary penalty if they return the amount billed or take action to resolve collection actions within 30 days of being notified by the Department of Health Care Policy and Financing (HCPF). To establish a claim for the civil monetary penalty, a Medicaid client or person acting on behalf of the client must notify HCPF. This penalty does not apply if the individual misrepresents his or her Medicaid coverage status to the medical provider. Any civil monetary penalty imposed by HCPF may be appealed administratively.



HCPF may request a written response from any provider who endangers the health, safety, or welfare of Medicaid clients or fails to comply with the rules, manuals, or bulletins issued by HCPF, the Medical Services Board, or a fiscal agent of HCPF. The written response must describe how the provider will come into and ensure future compliance. If the provider disagrees with HCPF's findings that resulted in the request for a written response, the provider's response must include an explanation and reasons for the disagreement.