AN ACT CONCERNING FORENSIC AUDITS CONDUCTED BY THE DEPARTMENT OF SOCIAL SERVICES.

HB 7105 modifies how Connecticut's Department of Social Services conducts forensic audits on facilities participating in Medicaid. It directly affects nursing homes, chronic disease hospitals, rest homes with nursing supervision, residential care homes, and facilities for people with intellectual disabilities. Key provisions require 30 days' written notice before audits (unless health/safety risks or fraud exist), limit the use of "extrapolation" to calculate payment errors (only after documented failures to correct errors or when aggregate claims exceed $200,000 annually), and establish a clear process for facilities to dispute findings through exit conferences, rehearings, and binding arbitration. The bill aims to balance audit rigor with fair process for facilities.