Protecting Patients from Medicaid Fraud Act

Protecting Patients from Medicaid Fraud Act

This bill requires state Medicaid programs to consult with the Centers for Medicare & Medicaid Services (CMS) about provider screening and oversight requirements if they have not already opted to do so. Additionally, states that are not in compliance with these screening and oversight requirements must submit progress reports to the CMS annually.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4701 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 4701

To amend title XIX of the Social Security Act to increase provider and 
 supplier oversight under State Medicaid plans, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 27, 2021

Mr. Bergman (for himself and Mrs. Axne) 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 increase provider and 
 supplier oversight under State Medicaid plans, and for other purposes.

    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 ``Protecting Patients from Medicaid 
Fraud Act''.

SEC. 2. INCREASED PROVIDER AND SUPPLIER OVERSIGHT UNDER STATE MEDICAID 
              PLANS.

    Section 1902(kk) of the Social Security Act (42 U.S.C. 1936a(kk)) 
is amended--
            (1) in paragraph (1), by adding at the end the following 
        new sentence: ``In the case of a State which has not 
        participated in an optional consultation with the Secretary 
        with respect to the screening requirements under such section 
        1866(j)(2) as of the date of the enactment of this sentence, 
        the Secretary shall notify each such State and such a State be 
        required to consult with the Secretary with respect to such 
        requirements for providers and suppliers under the State 
        plan.'';
            (2) in paragraph (2), by adding at the end the following 
        new sentence: ``In the case of a State which has not 
        participated in an optional consultation with the Secretary 
        with respect to the oversight requirements under such section 
        1866(j)(3) as of the date of the enactment of this sentence, 
        the Secretary shall notify each such State and such a State be 
        required to consult with the Secretary with respect to such 
        requirements for providers and suppliers under the State 
        plan.''; and
            (3) by adding at the end the following new paragraph:
            ``(10) Ensuring compliance with screening and oversight 
        requirements for providers and suppliers.--In the case of any 
        State which is not in compliance with the requirements under 
        paragraphs (2) and (3) of section 1866(j)(2) with respect to 
        providers and suppliers under the State plan, for the purpose 
        of monitoring the progress of such a State in attaining 
        compliance with such requirements, such State shall, on an 
        annual basis, submit to the Secretary information the Secretary 
        determines appropriate.''.
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