2026 Minnesota Statutes
256B.0448 POSTPAYMENT REVIEW.
Subdivision 1.Purpose and authority.
The commissioner may conduct postpayment review of claims, encounters, cost reports, rate submissions, and other billings submitted for payment or reimbursement under this chapter to identify improper payments and recover payments made in violation of state or federal law or program requirements.
Subd. 2.Scope of review.
The commissioner may conduct postpayment review on a claim-by-claim basis or through other review methods authorized by state or federal law.
Subd. 3.Provider obligations.
(a) A provider subject to postpayment review must maintain documentation necessary to support claims, encounters, cost reports, rate submissions, other billings submitted for payment or reimbursement under this chapter, and compliance with program requirements.
(b) The commissioner may require a provider to submit records or supporting documentation relevant to a postpayment review.
(c) A provider's failure to provide requested records or supporting documentation to the commissioner according to the timeline specified by the commissioner may result in recovery of payments or sanctions under section 256B.064 and other applicable laws.
Subd. 4.Recovery and sanctions.
If postpayment review identifies an overpayment or other noncompliance with medical assistance payment requirements, the commissioner may recover payments and impose sanctions in accordance with section 256B.064 and other applicable laws.
Subd. 5.Relationship to other actions.
Conducting postpayment review of a provider under this section does not preclude the commissioner from conducting a preliminary investigation, full investigation, enhanced prepayment review, payment suspension, audit, overpayment recovery, sanction, or referral to law enforcement under this chapter or applicable federal law.
History:
Official Publication of the State of Minnesota
Revisor of Statutes