Senate narrows Medicaid audit recovery rules to avoid destabilizing provider recoveries

Senators voted to adopt amendment L003 to House Bill 14-12, which allows the Department of Health Care Policy and Financing to use statistical sampling and extrapolation but restricts extrapolation to confirmed overpayments rather than documentation deficiencies alone. Senator Frizzell and co-sponsors argued that federal guidance distinguishes true overpayments from documentation gaps and that using extrapolation only for confirmed overpayments prevents disproportionate recoveries that would destabilize providers and threaten children's access to care.