Current through 2024, ch. 69
Section 27-11-12 - Rights of medicaid provider or subcontractor; preliminary or final determination of overpaymentA. A medicaid provider or subcontractor may challenge:(1) the department's preliminary or final determination of overpayment as: (a) exceeding statutory authority;(b) arbitrary or capricious;(c) a failure to follow department procedure; or(d) not supported by substantial evidence;(2) the credentials of persons who participated in the audit or claims review; or(3) the methodology or accuracy of the department's audit.B. A medicaid provider or subcontractor may, but shall not be required to, conduct its own audit or sampling to challenge a preliminary or final determination of overpayment.Added by 2019, c. 215,s. 10, eff. 1/1/2020.