HB 1412: Department of Health Care Policy & Financing Statistical Sampling & Extrapolation

Official summary

Abstract published by the legislature (via Open States). Text as published by the legislature; reproduced verbatim.

If an audit of a medicaid provider who provides nonemergency medical transportation services or pediatric behavioral therapy is initiated after July 1, 2026, for services provided from January 1, 2022, through December 31, 2023, the act authorizes the department of health care policy and financing (HCPF) to determine and recover overpayments to a provider using statistical sampling and extrapolation. If an audit identifies a statistically significant pattern of alleged overpayments to a provider, the act authorizes the state auditor to use the same statistical sampling and extrapolation methods to audit services provided by the provider from January 1, 2024, through December 31, 2025.     If the audit identifies an alleged overpayment, HCPF is required to issue a notice of the alleged overpayment within 60 days after the alleged overpayment is identified. The notice of alleged overpayment must include the basis of the alleged overpayment, the rationale for the alleged overpayment, the methodology used to calculate the alleged overpayment, and information on how HCPF identified the alleged overpayment.     If HCPF enters into a contract for the purpose of conducting an audit, the contract must not be a contingency-based contract based on a percentage of the amount of recovery collected from the provider.     After HCPF completes an audit of a provider, the state auditor's office is required to conduct an examination to determine that proper statistical sampling and extrapolation methods were used by HCPF when determining whether overpayments were made to a provider. The state auditor shall annually present a report of the findings to the legislative audit committee and the joint budget committee.     The act reduces the general fund appropriation to HCPF for medical and long-term care services for Medicaid-eligible individuals by $6,861,775 and increases the cash fund appropriation to HCPF for medical and long-term care services for Medicaid-eligible individuals by $13,723,550.(Note: This summary applies to this bill as enacted.)

Sponsors

Sponsors by party (alphabetical): Democratic 6 · Republican 4

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. June 4, 2026Governor Signed
2. June 3, 2026Signed by the Speaker of the House
3. June 3, 2026Signed by the President of the Senate
4. June 3, 2026Sent to the Governor
5. April 28, 2026House Consideration of First Conference Committee Report result was to Adopt Committee Report - Repass
6. April 24, 2026Senate Consideration of First Conference Committee Report result was to Adopt Committee Report - Repass
7. April 17, 2026House Considered Senate Amendments - Result was to Not Concur - Request Conference Committee
8. April 16, 2026Senate Third Reading Passed - No Amendments
9. April 15, 2026Senate Second Reading Special Order - Passed with Amendments - Committee, Floor
10. April 14, 2026Senate Committee on Appropriations Refer Amended to Senate Committee of the Whole
11. April 13, 2026Introduced In Senate - Assigned to Appropriations
12. April 11, 2026House Third Reading Passed - No Amendments

Showing 12 most recent of 17 actions. Full history