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B-331769 1 (2020-02-03)

handle is hein.gao/gaobaearb0001 and id is 1 raw text is: G A U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 B-331769 February 3, 2020 The Honorable Chuck Grassley Chairman The Honorable Ron Wyden Ranking Member Committee on Finance United States Senate The Honorable Frank Pallone, Jr. Chairman The Honorable Greg Walden Ranking Member Committee on Energy and Commerce House of Representatives The Honorable Richard Neal Chairman The Honorable Kevin Brady Ranking Member Committee on Ways and Means House of Representatives Subject: Department of Health and Human Services, Centers for Medicare & Medicaid Services: Medicare, Medicaid, and Children's Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process Pursuant to section 801 (a)(2)(A) of title 5, United States Code, this is our report on a major rule promulgated by the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) entitled Medicare, Medicaid, and Children's Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process (RIN: 0938- AS84). We received the rule on January 17, 2020. It was published in the Federal Register as a final rule with comment period on September 10, 2019. 84 Fed. Reg. 47794. The effective date of the rule is November 4, 2019. According to CMS, the final rule implements statutory provisions that require Medicare, Medicaid, and Children's Health Insurance Program (CHIP) providers and suppliers to disclose certain current and previous affiliations with other providers and suppliers. CMS states that the rule also provides the agency with additional authority to deny or revoke a provider's or supplier's Medicare enrollment in certain specified circumstances. According to CMS, the provisions in this rule are necessary to address various program integrity issues and vulnerabilities by enabling CMS to take action against unqualified and potentially fraudulent entities and individuals, which in turn could deter other parties from engaging in improper behavior.

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