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Increased Scrutiny for Medicaid Healthcare Providers.

New rules will increase oversight of healthcare providers in the Medicaid program. Starting in 2028, states must regularly check if providers have been excluded from other federal or state programs. This aims to protect public funds and ensure that medical services are provided by trustworthy entities.
Key points
Beginning January 1, 2028, states must check Medicaid providers during enrollment and monthly thereafter.
Checks will verify if a provider has been terminated from federal Medicare or other state Medicaid programs.
The goal is to prevent fraud and abuse in the healthcare system, potentially leading to better use of public funds.
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Introduced
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Additional Information
Print number: 119_HR_1875
Sponsor: Rep. Langworthy, Nicholas A. [R-NY-23]
Process start date: 2025-03-05