Sec. 2. (a) The office and a managed care organization that has contracted with the office under this article shall perform a recovery audit to ensure the integrity of the Medicaid program.
(b) The office shall contract with a recovery auditing entity to perform the recovery audit. A contract with a recovery auditing entity must include the following services:
(1) Review of claims submitted by providers or other individuals furnishing items and services for payment by the Medicaid program to determine whether overpayment or underpayment occurred.
(2) Recovery of identified overpayments and payment to providers of identified underpayments.
(c) A managed care organization may either perform the recovery audit internally or contract with a recovery auditing entity to perform the recovery audit. A recovery audit by a managed care organization, whether performed internally or through a contract with a recovery auditing entity, must meet the requirements of subsection (b) and section 3 of this chapter.
As added by P.L.134-2019, SEC.2.