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Physicians and Advocates Tell Committee Recoupment Rules Hurt Practices; Bill Would Shorten Lookback and Bar Appeal Fees
Summary
Proponents of Senate Bill 162, including the Ohio State Medical Association and behavioral health representatives, told the Senate committee that insurers' "take backs" (recoupments) create financial instability for providers and that the bill would shorten the audit lookback period and bar insurers from charging providers to appeal recoupment.
Monica Hickel, vice president of advocacy for the Ohio State Medical Association (OSMA), and OSMA President John Bastulli, M.D., testified in support of Senate Bill 162, which OSMA says would limit insurers' ability to retroactively recoup payments and would prohibit insurers from charging providers for filing appeals of alleged overpayments.
"Take backs are also referred to claw backs in the healthcare space," Hickel said. She described the existing disparity in timelines: providers typically have 90 to 180 days to…
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