Lawmakers passed a bill April 5 designed to bolster the fiscal integrity of Nebraska’s Medicaid program.
Introduced in 2011 by the Health and Human Services Committee, LB541 was advanced to final reading last session. Lawmakers returned the bill to select file Feb. 24 and amended it to require the state Department of Health and Human Services (DHHS) to report to the Legislature by Dec. 1, 2012 on the status of all contracts authorized by the bill.
LB541 requires DHHS to contract with one or more recovery audit contractors for the following services:
• provider claim review and overpayment recovery;
• cost avoidance through identifying third-party liability;
• cost recovery of third-party liability through postpayment reimbursement; and
• identification and recovery of claims that were the result of accident or neglect and payable to a casualty insurer.
The bill limits contingent fees to no more than 12.5 percent of amounts recovered. All amounts recovered and savings generated from the contracts will be returned to the state’s Medicaid program.
LB541 passed 49-0.