Title VI. Transparency and Program Integrity
Additional Medicaid Program Integrity Provisions
The Act imposes tough new rules for the Medicaid program that will reduce fraud and save money for cash-strapped states.
The Act sets up new rules to prevent individuals or entities that were terminated from Medicare or Medicaid in one state from setting up practice in another state. And it requires Medicaid agencies to exclude individuals or entities from participating in Medicaid for a specified period if it (1) has failed to repay overpayments; (2) is suspended, excluded, or terminated from participation in any Medicaid program; or (3) is affiliated with an individual or entity that has been suspended, excluded, or terminated from Medicaid participation.
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