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2015 SESSION

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HB 2251 Appeals of adverse initial determinations of overpayment; attorney fees.

Introduced by: Joseph E. Preston | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Appeals of adverse initial determinations of overpayment; attorney fees. Provides that in cases in which the Department of Medical Assistance Services makes an initial determination that an overpayment has been made to a provider and the provider substantially prevails on the merits of an appeal of that decision, the provider shall be entitled to attorney fees. Currently, the law requires that the provider substantially prevail on the merits of the appeal and demonstrate that the Department's position was not substantially justified. The bill also provides that a provider will be deemed to have substantially prevailed and shall be eligible to recover attorney fees if the amount the provider is reimbursed following the appeal is equal to at least 80 percent of the original payment received.


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