Guidelines for Medicaid recovery audits approved

Senators passed a bill May 29 that sets guidelines for Medicaid recovery audits in Nebraska.

LB315, sponsored by Omaha Sen. Sara Howard, establishes new guidelines for Recovery Audit Contractors to follow while conducting audits as required by the Affordable Care Act.

Among other provisions, the bill:
• clarifies that only one audit may be conducted at a time;
• excludes from review claims otherwise audited;
• requires claim review within two years of the date of payment;
• aligns the appeals process with DHHS practice;
• requires procedures for resubmitting corrected claims; and
• requires audit completion within 60 days of receipt of all requested material.

LB315 passed on a 44-0 vote.

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