“To amend title XIX of the Social Security Act to require State Medicaid fraud control units to conduct annual audits.”
No CRS summary available for this bill.
This section requires State Medicaid fraud control units to audit a statistically valid sample of high-risk providers and suppliers at least annually, beginning 1 year after enactment, in coordination with the HHS Inspector General and State Medicaid agency, to identify fraud, waste, and abuse. It requires the units to summarize audit results, including overpayments identified and collected, in their annual reports to the Secretary and permits certification or recertification if the unit implements an approved corrective action plan. High-risk providers include those designated under the screening process in section 1866(j)(2) or identified by the unit based on billing patterns, ownership changes, or other risk factors.