Chief Patron: Sickles
Medicaid and Correctional Healthcare Audit and Recovery (language only)

Item 60 #1h

Language
Page 40, line 24, prior to "On", insert "A."
Page 40, after line 31, insert:
"B.  The Medicaid Fraud Control Unit shall use coding compliance diagnosis-related reviews; transfers, readmissions, and cost outlier reviews, outpatient 72-hour rule reviews, payment and billing error reviews and other technology to assure that the correctional health care system is billed correctly and that overpayments are recovered from off-site specialists, hospitals, and other off-site providers of health care to offenders in the custody of the Department of the Corrections.  In addition, the Medicaid Fraud Control Unit will use similar tools to assure that Medicaid is billed for appropriate inpatient hospital and professional services incurred for the care of Medicaid-eligible hospitalized offenders in the custody of the Department of Corrections."

Explanation
(This amendment requires the Medicaid Fraud Control Unit within in the Office of the Attorney General to use various technology and data review to assure that the Department of Corrections to recover improper payments or overpayments for off-site healthcare services provided to inmates, and to use these same techniques to assure Medicaid is not overbilled for healthcare services provided to Medicaid-eligible hospitalized inmates.)