Bill > HR1875

This bill amends the Social Security Act to enhance Medicaid provider screening requirements. Starting January 1, 2028, states will be required to conduct more rigorous screening of healthcare providers when they enroll, reenroll, or validate their enrollment in the Medicaid program. Specifically, states must check databases at least monthly to determine if a provider has been terminated from participation in Medicare (title XVIII) or Medicaid programs in other states. This screening process aims to improve accountability and reduce fraud by ensuring that providers with a history of termination in other programs are identified and potentially prevented from participating in Medicaid. The bill represents an additional layer of oversight in the Medicaid provider enrollment process, seeking to maintain the integrity of the healthcare provider network and protect public funds from potential misconduct or inappropriate billing practices.

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https://www.congress.gov/bill/119th-congress/house-bill/1875/all-info