This bill establishes new limitations on post-payment reviews of Medicaid provider claims under both fee-for-service and managed care administration. Specifically, it stipulates that such reviews, which do not involve fraud or misrepresentation, can only be conducted on claims that are less than twelve months old from the date of payment. Furthermore, if a provider is identified as having received an overpayment for claims that are twelve months or older, they will not be required to repay those amounts or have them offset against future reimbursements.

Additionally, the bill allows for any improper payments identified during a review to be resubmitted by the provider as a claims adjustment. The provisions outlined in this bill are intended to streamline the claims review process and provide financial protection for providers regarding older claims. The bill is effective immediately upon enactment.