The proposed bill aims to amend existing laws regarding audits of healthcare providers by establishing the "Arkansas Medical Audit Bill of Rights Act." This new subchapter outlines specific rights and procedures that auditors must follow when conducting audits on healthcare providers. Key provisions include requirements for advance notice of audits, the necessity for auditors to consult with specialists of the same field, and protections against penalizing clerical errors as fraud. Additionally, the bill stipulates that recoupments cannot be based on documentation requirements beyond those mandated by law and that audits should not exceed a 24-month period from the claim submission date.
Furthermore, the bill mandates that healthcare providers be given a minimum of 60 days to address discrepancies found in audits and establishes an appeals process for unfavorable audit reports. It also prohibits the use of extrapolation in calculating recoupments or penalties. Notably, the bill excludes audits related to Medicaid fraud or abuse from its provisions and assigns the Insurance Commissioner the responsibility to create rules for its implementation. Overall, the bill seeks to enhance transparency and fairness in the auditing process for healthcare providers in Arkansas.