Bill Status of HB 4635   97th General Assembly


Short Description:  PROGRAM INTEGRITY-MEDICAD&CHIP

House Sponsors
Rep. Camille Y. Lilly

Last Action  View All Actions

DateChamber Action
  1/8/2013HouseSession Sine Die

Statutes Amended In Order of Appearance
New Act

Synopsis As Introduced
Creates the Program Integrity for Medicaid and the Children's Health Insurance Program Act. Provides that it is the intent of the General Assembly to implement waste, fraud, and abuse detection, prevention, and recovery solutions to improve program integrity for Medicaid and the Children's Health Insurance Program in the State and create efficiency and cost savings through a shift from a retrospective "pay and chase" model to a prospective pre-payment model; and to comply with program integrity provisions of the federal Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. In furtherance of these goals, requires the State to implement several technologies and services including (i) provider data verification and provider screening technology; (ii) state-of-the-art clinical code editing technology; (iii) state-of-the-art predictive modeling and analytics technologies; (iv) fraud investigative services; and (v) Medicaid and CHIP claims audit and recovery services. Requires the State to either contract with The Cooperative Purchasing Network (TCPN) to issue a request for proposals (RFP) when selecting a contractor or use the specified contractor selection process. Contains provisions concerning contracts, reporting requirements, and savings. Effective immediately.

Actions 
DateChamber Action
  2/1/2012HouseFiled with the Clerk by Rep. Camille Y. Lilly
  2/1/2012HouseFirst Reading
  2/1/2012HouseReferred to Rules Committee
  2/15/2012HouseAssigned to Appropriations-Human Services Committee
  3/9/2012HouseRule 19(a) / Re-referred to Rules Committee
  1/8/2013HouseSession Sine Die

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