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| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB2832 Introduced 2/19/2021, by Rep. Jackie Haas SYNOPSIS AS INTRODUCED:
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Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that in order to recover an overpayment by recoupment or offset of future payments, a managed care organization's post-payment audit of any claim submitted by a provider must be completed no later than 2 years after the claim's payment date. Provides that the 2-year time limit does not apply to claims that are (i) submitted fraudulently, (ii) known, or should have been known, by the provider to be a pattern of inappropriate billing according to standard provider billing practices, or (iii) subject to any federal law or regulation that permits post-payment audits beyond 2 years.
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| | A BILL FOR |
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| | HB2832 | | LRB102 13984 KTG 19336 b |
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| 1 | | AN ACT concerning public aid.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Public Aid Code is amended by |
| 5 | | adding Section 5-43 as follows:
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| 6 | | (305 ILCS 5/5-43 new) |
| 7 | | Sec. 5-43. MCO post-payment audit; time period limitation. |
| 8 | | Notwithstanding any provision of this Code to the contrary, in |
| 9 | | order to recover an overpayment by recoupment or offset of |
| 10 | | future payments, a managed care organization's post-payment |
| 11 | | audit of any claim submitted by a provider must be completed no |
| 12 | | later than 2 years after the claim's payment date. The 2-year |
| 13 | | time limit does not apply to claims that are (i) submitted |
| 14 | | fraudulently, (ii) known, or should have been known, by the |
| 15 | | provider to be a pattern of inappropriate billing according to |
| 16 | | standard provider billing practices, or (iii) subject to any |
| 17 | | federal law or regulation that permits post-payment audits |
| 18 | | beyond 2 years.
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