This bill seeks to clarify and enhance the authority of the commissioner of human services regarding the imposition of sanctions on individuals or entities involved in medical assistance programs. It introduces new subdivisions to sections 245.095 and 256B.064, explicitly stating that the commissioner's authority to impose sanctions is not modified or limited by these sections. Key amendments to section 256B.064 include a comprehensive list of sanctions, such as the suspension or termination of program participation and fines for incomplete documentation. The bill also mandates that individuals or entities excluded from Medicare face mandatory suspension or termination from the program, and it allows for the withholding or reduction of payments without prior notice under certain conditions, such as credible allegations of fraud.

Additionally, the bill amends the procedures for withholding or reducing payments, requiring the commissioner to notify affected parties within five days and provide reasons for the action, while allowing them to submit evidence. It introduces a provision for the forfeiture of payments held due to criminal convictions related to health services, regardless of the amount. The bill emphasizes the importance of checking an exclusion list monthly and terminates payments to any listed individuals or entities. It also clarifies the responsibilities of the commissioner and entities regarding fraud reporting, establishes immunity for good faith reporters, and ensures confidentiality of their identities. All provisions of the bill are set to take effect the day following final enactment.

Statutes affected:
Introduction: 245.095, 256B.064