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90‑day administrative review for payment withholds fails to clear committees after debate over appeals and CMS implications
Summary
Senator Abler's A7, which would require a periodic administrative‑law-judge reexamination (every 90 days) of payment withholds, drew support as a mechanism to prevent indefinite holds but faced objections about caps, what constitutes 'legal proceedings', and federal (CMS) consequences; it failed to win votes in the joint committees.
Senator Abler's amendment A7 proposed an automatic reexamination every 90 days—conducted by an administrative law judge—of whether a payment withhold imposed by DHS continues to meet the "credible allegation of fraud" standard and whether the department is making reasonable investigative progress.
Staff described the operational mechanics: an ALJ would review submitted evidence and…
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