HB2832 102ND GENERAL ASSEMBLY

LRB102 13984 KTG 19336 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB2832

Introduced 2/19/2021, by Rep. Jackie Haas

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-43 new

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.

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by adding Section 5-43 as follows:

(305 ILCS 5/5-43 new)

Sec. 5-43. MCO post-payment audit; time period limitation. Notwithstanding any provision of this Code to the contrary, 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. 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.