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Stricter Medicaid Provider Screening to Combat Fraud and Abuse.

This law mandates more frequent and rigorous screening of medical service providers within the Medicaid program, effective January 1, 2027. States will be required to regularly check if a provider has been terminated from Medicare or Medicaid programs in other states. The goal is to protect public funds and ensure that health services are delivered by trustworthy professionals.
Key points
Starting January 1, 2027, states must screen Medicaid providers at least monthly.
Screening includes checking if the provider has been previously terminated from Medicare or Medicaid programs in any other state.
The changes aim to reduce fraud and abuse in publicly funded healthcare, enhancing program security for beneficiaries.
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Additional Information
To amend title XIX of the Social Security Act to further require certain additional provider screening under the Medicaid program.
Print number: HR 8112
Sponsor: Rep. D'Esposito, Anthony [R-NY-4]
Process start date: 2024-04-23