This bill addresses transparency in the Medicaid program.
This bill:
- requires the Division of Integrated Healthcare (division) to establish and maintain a database of Medicaid encounter data submitted by managed care organizations;
- requires certain participants in the Medicaid program to: have audits conducted by independent auditors;identify, report on, and repay improper payments; anddevelop corrective action plans to address improper payments;
- requires the Department of Health and Human Services to publish audits, reports of improper payments, and corrective action plans;
- prohibits conflicts of interest for actuarial firms providing services to Medicaid program participants;
- provides rulemaking authority, including for sanctions for violations of the provisions of this bill;
- defines terms; and
- makes technical and conforming changes.