The Patient Protection and Affordable Care Act (ACA) is bringing unparalleled change to Medicaid, Medicare and private insurance. With billions of dollars lost each year through fraud and improper payments, State Agencies are taking an active role in screening and ongoing monitoring of the providers that service their constituents and bill their system. The Affordable Care Act requires providers and suppliers who wish to enroll in the Medicare, Medicaid or CHIP programs to undergo screening so that an agency can properly evaluate the level of risk (i.e., likelihood for fraud, waste and abuse) that these entities present to the programs.
The final rule is designed to ensure “that only legitimate providers and suppliers are enrolled in Medicare, Medicaid, and CHIP, and that only legitimate claims will be paid.”
Learn more about this ACA regulation and how LexisNexis can help you meet these new provider requirements by downloading the brief.
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