Relates to automated payment detection, prevention and recovery solutions to reduce correctional healthcare overpayments, billed for eligible services

BILL NUMBER:S6494A

Title of bill

An act to amend the correction law and the social services law, in relation to the development and implementation of automated payment detection, prevention and recovery solutions to reduce correctional healthcare overpayments, and to require that private health insurance providers and Medicaid are billed for eligible inpatient hospital and professional services

Purpose or general idea of bill

This bill seeks to implement savings for state correctional healthcare and prevent Medicaid fraud within correctional facilities, while ensuring that patients receive proper services.

Summary of specific provisions

Section 1- Legislative intent.

Section 2 - Part 1 provides that the new sections apply to all state correctional healthcare systems and state contracted managed correctional healthcare systems.

- Part 2 requires implementation of procedures to utilize Medicaid for reimbursement of correctional healthcare costs and defines the technological services that would be provided to prevent errors and potential overbilling.

- Part 3 details the procedures that would be taken to prevent fraud.

- Part 4 states that the state may contract to have services performed and that savings of this service will be used towards administration and operation.

Section 3 - Provides that any Medicaid costs not covered by the Federal Government will be covered entirely by the state, without local contribution.

Section 4 - Effective date.

Justification

This bill seeks to reduce costs to the state for correctional healthcare services. Currently, correctional healthcare costs are borne entirely by the state, even though many, if not all, of these costs might be covered under either Medicaid or private health insurance plans. This bill would require to utilize Medicaid and private insurance coverage when appropriate to reduce costs to the state. Local governments would not be responsible for any part of the Medicaid cost for correctional healthcare.

Prior legislative history

New bill

Fiscal implications

The comptroller has estimated that utilizing Medicaid reimbursement for correctional healthcare might save the state up to $20 million per year.

Effective date

This act shall take effect on the first day of January next succeeding the date upon which it shall have become a law.