Public Comments for 01/14/2021 Labor and Commerce
HB1807 - Health maintenance organizations; insolvency.
HB1829 - Health insurance; credentialing health care providers.
Managed care organizations are contracting with third party audit organizations to recoup payments made to home care providers. Often times, these third-party organizations are aggressive, are paid based on the amount of reimbursement recovered and apply arbitrary standards inconsistent with both Medicaid and Medicare guidelines. This bill does the following which is consistent with Medicare policy. Any changes made to provider requirements must be communicated in writing to all home care, home health or hospice providers 90 days prior to their effective date. Home care and hospice agencies shall have access to clear and consistent training on the audit expectation and process prior to implementation. These audit processes would consist of an opportunity for home care and hospice agencies to work collaboratively and correct any technical errors identified, provided the plan of care was followed and patient care was delivered. All appeals processes shall be conducted by an organization that is not a subdivision of either the managed care organization or the third-party audit organization. This bill would restore a fair and equitable audit process. I ask that you please support this legislation.