DHFS-DOC-MEDICAID-INMATES

Creates the Medicaid Billing for Inmate Inpatient Hospital and Professional Services Act. Provides that it is the intent of the General Assembly to reduce the State's correctional healthcare costs by requiring hospitals and other medical service providers to bill Medicaid for eligible inmate inpatient hospital and professional services; implement improper payment detection, prevention, and recovery solutions to reduce correctional healthcare costs by introducing prospective solutions to eliminate overpayments and retrospective solutions to recover those overpayments that have already occurred; cap all contract and non-contract correctional healthcare reimbursement rates at no more than 110% of the federal Medicare reimbursement rate; and embrace technologies to better manage correctional healthcare expenses. In furtherance of these goals, requires the State to implement several technologies and services, including (i) clinical code editing technology; (ii) predictive modeling and analytics technologies; and (iii) claims audit and recovery services. Requires the State to either sign an intergovernmental agreement with another state already receiving these services, 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.