HB407 Alabama 2014 Session

Summary

Primary Sponsor

Rod Scott

Democrat

Co-Sponsor

Oliver Robinson

Session

Regular Session 2014

Title

Health care, costs, inmates, Corrections Department and Medicaid, adoption and implementation of cost, saving strategies to deal with overpayments

Summary

HB407 requires the Department of Corrections, with Medicaid, to adopt and run a plan to reduce health-care overpayments for inmate care, funded by the savings.

What This Bill Does

The bill would have the Department of Corrections, in cooperation with the Medicaid Agency, adopt and implement a plan to cut overpayments for inmate health care. It uses automated code-editing technology to catch and fix billing errors before claims are paid, and includes audits and recovery of overpayments for nonfraudulent issues. Post-payment reviews would verify diagnoses and procedure codes, and automated payment detection would ensure Medicaid is billed only for eligible inpatient and professional services. The plan would apply to state correctional health care systems and state contracted managed health care services, and savings must cover the plan's costs, with the state funding costs only from actual savings and contractors paid from those savings under flexible models.

Who It Affects

• Incarcerated individuals who receive health care, through more accurate billing and reduced overpayments.
• The Alabama Department of Corrections, the Medicaid Agency, and health care providers/contractors involved in inmate health care and billing, who will implement the plan, conduct audits, and may be paid from savings under various reimbursement methods.

Key Provisions

• Adopt and implement a plan to reduce health care overpayments by using state-of-the-art clinical code editing technology to automate claims resolution and improve cost containment; edits applied automatically before adjudication.
• Implement correctional health care claims audit and recovery services to identify improper payments due to nonfraudulent issues, conduct post-payment reviews, and recover validated overpayments.
• Implement automated payment detection, prevention, and recovery to ensure Medicaid is billed for eligible inpatient hospital and professional services.
• The Department of Corrections and the Medicaid Agency shall contract for these services so that the savings exceed the costs of implementation and administration; technology services are funded from the savings, with the state bearing only actual savings costs.
• Reimbursement to contractors may be based on multiple models (percentage of savings, per-beneficiary per-month, per-transaction, case-rate, or blended) and may include performance guarantees.
• Effective date: the act takes effect on the first day of the third month after passage and governor approval.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health Care