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Bill would limit extrapolation in Medicaid audits after providers report large retroactive recoveries

2397199 · February 25, 2025
AI-Generated Content: All content on this page was generated by AI to highlight key points from the meeting. For complete details and context, we recommend watching the full video. so we can fix them.

Summary

Senate Committee on Health Care heard public testimony on Senate Bill 61 on Feb. 25, 2025; the bill would limit extrapolation from very small audit samples in Medicaid overpayment reviews and require larger representative samples or documented overpayments before broad recoveries.

Senate Committee on Health Care heard public testimony on Senate Bill 61 on Feb. 25, 2025. The measure would set guardrails for Medicaid program integrity audits, narrowing situations in which contracted auditors may extrapolate an error rate from a small sample to the full claims population and requiring a larger audit sample or actual overpayment findings before broad recoveries are pursued.

Sponsor Senator Caden described provider complaints during the COVID period in which auditors extrapolated small samples to recover substantial…

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