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This bill would add a new fraud-prevention step to Medicaid. Starting in 2027, states would have to check whether a doctor, clinic, or other Medicaid provider is listed as deceased before enrolling them, when renewing their enrollment, and at least every three months afterward. The goal is to stop payments from going to providers who have died and to help states catch mistakes or fraud sooner.
- States would need to use the Death Master File, a federal record used to identify people who have died.
- The check would happen when a provider or supplier first enrolls in Medicaid and again when that enrollment is revalidated.
- After enrollment, states would have to run the check at least once every quarter.
- The new rule would begin on January 1, 2027.
Official Summaries
Medicare and Medicaid Fraud Prevention Act
This bill provides statutory authority for the requirement that state Medicaid programs check, as part of the provider enrollment and reenrollment process, whether providers are deceased through the Social Security Administration's Death Master File. The bill requires states to continue to check this database on at least a quarterly basis after providers are enrolled.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2309 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 2309
To amend title XIX of the Social Security Act to require certain
additional provider screening under the Medicaid program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 24, 2025
Mr. Peters (for himself, Mr. Evans of Colorado, Mr. Suozzi, Ms.
Malliotakis, and Mr. Kennedy of Utah) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to require certain
additional provider screening under the Medicaid program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare and Medicaid Fraud
Prevention Act''.
SEC. 2. MEDICAID PROVIDER SCREENING REQUIREMENTS.
Section 1902(kk)(1) of the Social Security Act (42 U.S.C.
1396a(kk)(1)) is amended--
(1) by striking ``The State'' and inserting:
``(A) In general.--The State''; and
(2) by adding at the end the following new subparagraph:
``(B) Additional provider screening.--Beginning
January 1, 2027, as part of the enrollment (or
revalidation of enrollment) of a provider or supplier
under this title, and not less frequently than
quarterly during the period that such provider or
supplier is so enrolled, the State conducts a check of
the Death Master File (as such term is defined in
section 203(d) of the Bipartisan Budget Act of 2013) to
determine whether such provider or supplier is
deceased.''.
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