Medicaid Overpayment Recovery via Statistical Sampling and Extrapolation
Summary
Colorado Governor signed HB1412 into law, authorizing the Department of Health Care and Financing to use statistical sampling and extrapolation methods to recover Medicaid overpayments from providers. The bill includes appropriation provisions for implementation. Healthcare providers participating in Medicaid should prepare for potential overpayment recovery audits using these new statistical methods.
What changed
Colorado enacted House Bill 1412, granting the Department of Health Care Policy & Financing explicit statutory authority to employ statistical sampling and extrapolation when recovering overpayments made to healthcare providers for Medicaid services. The bill, sponsored by a bipartisan coalition including Representatives Sirota, Taggart, Brown and Senators Bridges, Kirkmeyer, and Amabile, passed during the 2026 Regular Session and was signed on April 6, 2026.
Healthcare providers participating in Colorado Medicaid should monitor for implementing guidance from the Department regarding how statistical sampling will be applied to overpayment recovery calculations. Providers should ensure billing records and documentation practices support potential extrapolation-based audits. The appropriation provision indicates state resources are being allocated to implement this recovery methodology.
What to do next
- Review current Medicaid billing records for accuracy and potential overpayment exposure
- Monitor Department of Health Care Policy & Financing for implementing guidance on sampling methodology
- Ensure documentation practices support potential statistical sampling audits
Source document (simplified)
ChangeBridge / Colorado / HB1412 Signed by Governor HB1412 House Bill Signed by Governor 2026-04-06
Department of Health Care Policy & Financing Statistical Sampling & Extrapolation
Concerning authorizing the department of health care policy and financing to use statistical sampling and extrapolation to recover overpayments to providers for certain medicaid services, and, in connection therewith, making and reducing an appropriation.
Bill Details
State Colorado
Session 2026 Regular Session
Chamber House
Committee Appropriations
Official Source leg.colorado.gov/bills/HB26-1412
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Sponsors
Emily Sirota (Rep - D) Rick Taggart (Rep - R) Jeff Bridges (Sen - D) Barbara Kirkmeyer (Sen - R) Kyle Brown (Rep - D) Judith Amabile (Sen - D)
Action History
2026-04-06 H Introduced In House - Assigned to Appropriations
Committee Referrals
2026-04-06 H Appropriations
Bill Text Versions
1969-12-31 Introduced
Subjects
Health Care & Health Insurance Legislative data powered by LegiScan (CC BY 4.0)
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