House Bill No. 7105 seeks to amend Section 17b-99a of the general statutes to enhance the Department of Social Services' (DSS) authority in conducting forensic audits of various licensed facilities, including chronic and convalescent nursing homes and residential facilities for individuals with intellectual disabilities. The bill introduces a definition for "forensic audit" and requires the Commissioner of Social Services to notify facilities at least thirty days prior to an audit, except in cases of health or safety concerns or evidence of vendor fraud. It also establishes procedures for audits, including the production of preliminary and final reports, exit conferences, and the opportunity for facilities to contest findings. Notably, the bill deletes references to rates under section 17b-340 and adds section 17b-340d, reflecting updates in the regulatory framework.

Additionally, the bill mandates that facilities cooperate with audits and provide necessary assistance within ten business days, with penalties for non-compliance reaching up to $1,000 per day. Facilities may be held liable for audit costs, which can total up to $100,000, and DSS is authorized to recover these costs by withholding Medicaid payments. The legislation also includes provisions for facilities to request a fair hearing regarding any penalties assessed. Overall, HB7105 aims to improve financial compliance and accountability within Medicaid-participating facilities while providing support and training to help them adhere to regulatory standards.

Statutes affected:
Raised Bill:
HS Joint Favorable:
File No. 468: