Department of Health and Human Services, Centers for Medicare & Medicaid Services and Office of Inspector General: Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers
GAO-11-361R, Feb 17, 2011
GAO reviewed the Department of Health and Human Services (Department), Centers for Medicare & Medicaid Services and Office of Inspector General's new rule on Medicare, Medicaid, and children's health insurance programs. GAO found that (1) the final rule with comment period will implement provisions of the Affordable Care Act (ACA) that establish procedures under which screening is conducted for providers of medical or other services and suppliers in the Medicare program and providers in the Medicaid or Children's Health Insurance Program (CHIP). The final rule with comment period also implements an application fee imposed on institutional providers and suppliers. Additional elements to be implemented include temporary moratoria that may be imposed if necessary to prevent or combat fraud, waste, and abuse under Medicare, Medicaid, and CHIP, and requirements for suspension of payments pending credible allegations of fraud in the Medicare and Medicaid programs; and (2) the Department complied with the applicable requirements in promulgating the rule.