Change requirements relating to program integrity audits under the Medical Assistance Act

LB 381 amends Nebraska's Medical Assistance Act to update rules for program integrity audits conducted by contractors. It requires contractors to provide clear written justification for starting audits, limit review periods to one year (except for fraud), send detailed audit results within 180 days, and notify providers of overpayment determinations with specific details like beneficiary names and claim numbers. The bill also mandates that audits be conducted by healthcare professionals in relevant specialties, requires advance notice for onsite audits (at least 10 business days), and prohibits recovery of payments for services with prior authorization. These changes directly affect medical providers and program integrity contractors by standardizing audit procedures and improving transparency in billing disputes.