HB 2797: Health Care Authority; prohibiting use of certain methodology; audits; fraud reporting; requiring joint collaboration between Department of Mental Health and Substance Abuse Services and Department of Human Services; duties; emergency. - Oklahoma

House Committee Substitute → Floor (House) · 3 edits

MINOR

The bill text was updated from the House Committee Substitute version to the Floor version, primarily changing the document header and page footers to reflect the official floor submission. The substantive policy content, including definitions, prohibitions on audit methodologies, and program requirements, remains unchanged.

Scope change

No change in the bill's scope or applicability; the changes are limited to document formatting and version identification.

TECHNICAL

Updated the document title and header to indicate this is the 'Floor (House)' version of the bill, replacing the 'Committee Substitute' label.

Changed the page footer text from 'Req. No. 13803' to 'HB2797 HFLR' to reflect the new version status.

Adjusted line spacing and indentation in the title and summary sections to match the formatting of the floor version.

Proposed Committee Substitute (full committee) 1 → House Committee Substitute · 3 edits

MINOR

The bill was re-submitted by adding two new Senate sponsors and updating the title to reflect these changes. Additionally, the definition of 'health-related services' was expanded to include specific clinical tasks like range of motion exercises and basic nursing care, provided they are performed under strict supervision and with proper physician orders.

Scope change

The bill's scope was slightly broadened by adding new sponsors and expanding the definition of services covered under the program to include more clinical tasks.

ELIGIBILITY

Added Hall and Haste of the Senate as co-sponsors to the bill.

DEFINITION

Expanded the definition of 'health-related services' to include range of motion, supervision, and basic nursing care tasks like temperature checks and incontinent care, subject to training and physician orders.

TECHNICAL

Updated the bill title to reflect the new sponsors and adjusted page reference numbers.

Enrolled (final version) → Proposed Committee Substitute (full committee) 1 · 3 edits

MINOR

The bill was completely rewritten from scratch by the committee, replacing the original text with a new version that retains the core intent but alters specific statutory citations and formatting. The substantive policy regarding the prohibition of certain audit methodologies for Medicaid claims remains intact, though the specific section number cited for the Department of Human Services' duties was changed from 1020 to 2020.

Scope change

The bill's scope regarding the prohibition of extrapolation and statistical sampling for Medicaid audits remains unchanged, but the specific statutory section amended in Section 2 was modified from 56 O.S. 2021, Section 1020 to Section 2020.

TECHNICAL

The entire text of the bill was replaced with a new version, likely to correct errors or align with committee preferences.

The statutory citation for the Department of Human Services' duties was changed from Section 1020 to Section 2020 in the bill's summary and the amendment section.

Minor formatting changes were made to the definitions section, such as adjusting line breaks and spacing.

Engrossed → Enrolled (final version) · 1 edit · May 29, 2025

MINOR

The bill was finalized as an Enrolled version, confirming its passage and readiness for signature. The core policy content regarding the Oklahoma Health Care Authority's audit restrictions and the Department of Human Services' duties remains substantively identical to the Engrossed version, with no new policy requirements or changes to the effective dates.

Scope change

The scope of the bill remains unchanged; it continues to restrict the Oklahoma Health Care Authority from using extrapolation or statistical sampling to demand repayments for Medicaid claims submitted between January 2020 and November 2027.

TECHNICAL

The document format changed from 'Engrossed' to 'Enrolled,' indicating the bill has passed both legislative chambers and is in its final form for the Governor's signature, but the actual legal text and policy provisions were not altered.

Introduced → Engrossed · 6 edits · May 22, 2025

MODERATE

The bill was completely rewritten from a budget act to a healthcare regulation act. It now prohibits the Oklahoma Health Care Authority from using statistical extrapolation to demand repayments from Medicaid providers, nullifies past audits using those methods, and mandates new training programs for providers.

Scope change

The bill's scope shifted entirely from general state budgeting to specific regulations regarding Medicaid audit methodologies and provider compliance.

SCOPE

Removed the previous text which established the 'Budget and Finance Act of 2025' and set an effective date of November 1, 2025.

DEFINITION

Added new legal definitions for 'Error rate', 'Extrapolation', 'Probability sample', 'Sample', and 'Universe' to clarify audit standards.

REQUIREMENT

Prohibits the Oklahoma Health Care Authority from using extrapolation or statistical sampling to demand repayments from providers for claims submitted between January 2020 and November 2027.

Requires the Authority and Department of Human Services to create a joint training program for providers to be completed by November 1, 2027.

Amended existing law regarding the Department of Human Services to include specific services for persons with Prader-Willi syndrome and detailed definitions for health-related services.

ENFORCEMENT

Deems any past audits using prohibited methodology as invalid and void, removing the Authority's power to collect repayment or impose penalties based on those audits.

Health Care Authority; prohibiting use of certain methodology; audits; fraud reporting; requiring joint collaboration between Department of Mental Health and Substance Abuse Services and Department of Human Services; duties; emergency.

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